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Risk of immediate effects from F(ab)2 bivalent antivenin in Taiwan
J C Chen1, M J Bullard, T F Chiu
1Department of Emergency Medicine, Chang Gung Memorial Hospital, Kweishan Hsiang, Taoyuan Hsien, Taiwan, ROC. a9999999@ms3.hinet.net
Objective:
To evaluate the incidence of immediate adverse effects from equine fragment antigen binding F(ab)2 bivalent antivenin produced by the National Institute of Preventive Medicine (NIPM) in Taiwan.
Methods:
A retrospective chart review of patients presenting to a 600-bed general hospital over a 3-year period with snakebite who were treated with NIPM antivenin.
Results:
A total of 130 snakebite victims presented to the emergency department over the study period, and 159 vials of antivenin were given. One hundred two patients (78.5%; 95% CI: 70, 85) received only hemorrhagic bivalent antivenin, 2 (1.5%; 95% CI: 0, 5) received only neurotoxic bivalent antivenin, and the remaining 26 (20.0%; 95% CI: 13, 28) received both kinds of bivalent antivenin. Three received a second vial of hemorrhagic antivenin because of progression of symptoms. Forty-two patients (32.3%; 95% CI: 24, 41) had positive skin tests, but following pretreatment with diphenhydramine and hydrocortisone, only 1 patient developed a skin rash thought to be related to antivenin. No patient developed an anaphylactic reaction.
Conclusions:
The use of NIPM F(ab)2 antivenin in snakebite victims in Taiwan has a very low risk of acute adverse reactions.