Early Adverse Reactions to Snake Antivenom: Poison Center Data Analysis
Antivenom is an essential treatment for snake envenomation; however, early adverse reactions (EARs) are major limitations to its use. We performed a retrospective cross-sectional study using Ramathibodi Poison Center data (January 2016 to December 2017) to clarify the incidence and severity of EARs...
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MDPI AG
2022-10-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/14/10/694 |
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| author | Charuwan Sriapha Panee Rittilert Taksa Vasaruchapong Sahaphume Srisuma Winai Wananukul Satariya Trakulsrichai |
| author_facet | Charuwan Sriapha Panee Rittilert Taksa Vasaruchapong Sahaphume Srisuma Winai Wananukul Satariya Trakulsrichai |
| author_sort | Charuwan Sriapha |
| collection | DOAJ |
| description | Antivenom is an essential treatment for snake envenomation; however, early adverse reactions (EARs) are major limitations to its use. We performed a retrospective cross-sectional study using Ramathibodi Poison Center data (January 2016 to December 2017) to clarify the incidence and severity of EARs following different F(ab’)<sub>2</sub> antivenoms. Among 1006 envenomed patients, 684 (68%) received antivenom therapy with a total of 1157 doses, mostly green pit viper antivenom. The overall EAR incidence and rate were 22. 5% (154/684) and 15% (173/1157), respectively. The EAR rate following each type of antivenom was >10%, except for Russell’s viper antivenom (2.9%); the severe reaction rate was 2.6% (30/1157). Malayan pit viper bites caused a high incidence of EARs (37.8%) and the highest EAR rate (22.3%). Fifty-two cases developed anaphylaxis. All EARs occurred within 2 h after treatment initiation. No deaths were attributed to EARs. The duration of administration was significantly different between doses of antivenom that induced EARs and those that did not. In conclusion, all types and every dose of antivenom should be infused for 30–60 min. Preparation of resuscitation equipment and continuous clinical observation are crucial for at least 2 h after administration, and prompt treatment should be provided when EARs occur. |
| first_indexed | 2024-03-09T19:25:14Z |
| format | Article |
| id | doaj.art-c581d784a0974167a48cbb3d38fd71ae |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-09T19:25:14Z |
| publishDate | 2022-10-01 |
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| record_format | Article |
| series | Toxins |
| spelling | doaj.art-c581d784a0974167a48cbb3d38fd71ae2023-11-24T02:59:15ZengMDPI AGToxins2072-66512022-10-01141069410.3390/toxins14100694Early Adverse Reactions to Snake Antivenom: Poison Center Data AnalysisCharuwan Sriapha0Panee Rittilert1Taksa Vasaruchapong2Sahaphume Srisuma3Winai Wananukul4Satariya Trakulsrichai5Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandRamathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandSnake Farm, Queen Saovabha Memorial Institute, The Thai Red Cross Society, Bangkok 10330, ThailandRamathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandRamathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandRamathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandAntivenom is an essential treatment for snake envenomation; however, early adverse reactions (EARs) are major limitations to its use. We performed a retrospective cross-sectional study using Ramathibodi Poison Center data (January 2016 to December 2017) to clarify the incidence and severity of EARs following different F(ab’)<sub>2</sub> antivenoms. Among 1006 envenomed patients, 684 (68%) received antivenom therapy with a total of 1157 doses, mostly green pit viper antivenom. The overall EAR incidence and rate were 22. 5% (154/684) and 15% (173/1157), respectively. The EAR rate following each type of antivenom was >10%, except for Russell’s viper antivenom (2.9%); the severe reaction rate was 2.6% (30/1157). Malayan pit viper bites caused a high incidence of EARs (37.8%) and the highest EAR rate (22.3%). Fifty-two cases developed anaphylaxis. All EARs occurred within 2 h after treatment initiation. No deaths were attributed to EARs. The duration of administration was significantly different between doses of antivenom that induced EARs and those that did not. In conclusion, all types and every dose of antivenom should be infused for 30–60 min. Preparation of resuscitation equipment and continuous clinical observation are crucial for at least 2 h after administration, and prompt treatment should be provided when EARs occur.https://www.mdpi.com/2072-6651/14/10/694incidence of early adverse reactionsearly adverse reaction ratesnake antiveninadverse reactionsanaphylactic reactionssnakebite |
| spellingShingle | Charuwan Sriapha Panee Rittilert Taksa Vasaruchapong Sahaphume Srisuma Winai Wananukul Satariya Trakulsrichai Early Adverse Reactions to Snake Antivenom: Poison Center Data Analysis Toxins incidence of early adverse reactions early adverse reaction rate snake antivenin adverse reactions anaphylactic reactions snakebite |
| title | Early Adverse Reactions to Snake Antivenom: Poison Center Data Analysis |
| title_full | Early Adverse Reactions to Snake Antivenom: Poison Center Data Analysis |
| title_fullStr | Early Adverse Reactions to Snake Antivenom: Poison Center Data Analysis |
| title_full_unstemmed | Early Adverse Reactions to Snake Antivenom: Poison Center Data Analysis |
| title_short | Early Adverse Reactions to Snake Antivenom: Poison Center Data Analysis |
| title_sort | early adverse reactions to snake antivenom poison center data analysis |
| topic | incidence of early adverse reactions early adverse reaction rate snake antivenin adverse reactions anaphylactic reactions snakebite |
| url | https://www.mdpi.com/2072-6651/14/10/694 |
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