OBJECTIVES: To assess efficacy and safety of two equine F(ab')2 antivenoms currently used to treat envenoming by European vipers. DESIGN: Retrospective case review study. SETTING: Case records collected by the Swedish Poison Information Centre concerning patients treated in Swedish hospitals for bites by the common European adder, Vipera berus. SUBJECTS: Patients presenting with V. berus envenoming treated with antivenom (n = 30) and two groups of patients not given antivenom (n = 16 and n = 38). MAIN OUTCOME MEASURES: Clinical course and time in hospital were retrospectively studied and compared in patients treated or not treated with antivenom. RESULTS: There was a significantly lower incidence of extensive oedema (23 vs. 88%) and anaemia (10 vs. 50%) in the antivenom-treated group, and the hospital stay was shorter (median: 3 vs. 6 days). Antivenom treatment also resulted in prompt clinical improvement in the acute phase. Adverse effects consisting of urticaria and serum sickness occurred in 10% of the patients given antivenom. CONCLUSIONS: Antivenom treatment was associated with a reduced morbidity in severe V. berus envenoming. However, the occurrence of allergic side-effects is not negligible with this type of antivenom.
OBJECTIVES: To assess efficacy and safety of two equine F(ab')2 antivenoms currently used to treat envenoming by European vipers. DESIGN: Retrospective case review study. SETTING: Case records collected by the Swedish Poison Information Centre concerning patients treated in Swedish hospitals for bites by the common European adder, Vipera berus. SUBJECTS:Patients presenting with V. berus envenoming treated with antivenom (n = 30) and two groups of patients not given antivenom (n = 16 and n = 38). MAIN OUTCOME MEASURES: Clinical course and time in hospital were retrospectively studied and compared in patients treated or not treated with antivenom. RESULTS: There was a significantly lower incidence of extensive oedema (23 vs. 88%) and anaemia (10 vs. 50%) in the antivenom-treated group, and the hospital stay was shorter (median: 3 vs. 6 days). Antivenom treatment also resulted in prompt clinical improvement in the acute phase. Adverse effects consisting of urticaria and serum sickness occurred in 10% of the patients given antivenom. CONCLUSIONS: Antivenom treatment was associated with a reduced morbidity in severe V. berus envenoming. However, the occurrence of allergic side-effects is not negligible with this type of antivenom.
Authors: Michael Schroth; Jörg Jüngert; Matthias Schreiber; Gabriela Gerber-Zupan; Stefan Zink; Wolfgang Rascher Journal: Intensive Care Med Date: 2003-08-01 Impact factor: 17.440