Related Experiment Videos
Antivenom treatment in arachnidism
Geoffrey K Isbister1, Andis Graudins, Julian White
1Discipline of Clinical Pharmacology, University of Newcastle and Newcastle Mater Misericordiae Hospital, Newcastle, NSW, Australia. gsbite@bigpond.com
Journal of Toxicology. Clinical Toxicology
|June 17, 2003
Summary
Arachnid envenomations, particularly scorpion stings, cause significant illness. While antivenoms exist for some species like widow spiders and funnel web spiders, their efficacy is debated, especially for scorpion antivenoms, necessitating further trials for severe cases.
Area of Science:
- Medical Entomology
- Toxicology
- Clinical Medicine
Background:
- Arachnid envenomations represent a global health concern, with scorpion stings being a major cause of morbidity and mortality.
- Key venomous spiders include widow spiders (Latrodectus spp.), recluse spiders (Loxosceles spp.), Australian funnel web spiders (Atrax and Hadronyche spp.), and Brazilian armed spiders (Phoneutria spp.).
Purpose of the Study:
- To review the current status and efficacy of antivenoms for various medically significant arachnid envenomations.
- To highlight controversies and evidence gaps regarding antivenom effectiveness, particularly for scorpion and recluse spider bites.
Main Methods:
- Literature review of available antivenoms for arachnid envenomations.
- Analysis of in vitro studies, animal models, and clinical data on antivenom effectiveness and adverse reactions.
- Examination of evidence supporting or refuting antivenom use in specific envenomation scenarios.
Main Results:
- Antivenoms are available for widow spiders, Australian funnel web spiders, and Brazilian armed spiders, with varying degrees of reported success.
- Evidence supporting the effectiveness of Loxosceles antivenoms is limited, especially for local effects.
- Scorpion antivenoms have widespread availability, but their efficacy remains controversial, despite some evidence suggesting reduced pediatric mortality.
- Controlled trials have yielded mixed results, with some showing no effectiveness, particularly in less severe cases.
Conclusions:
- Antivenom use in severe envenomations is often justified, pending further controlled trials.
- Further research, including robust clinical trials, is crucial to definitively establish the efficacy of various antivenoms, especially for scorpion and recluse spider envenomations.
- Current antivenom use for arachnid envenomations requires careful consideration of available evidence and clinical context.