[Effect of reduction in the Bothrops antivenin dose administrated in patients bitten by the Bothrops snake]

Area of Science:

• Herpetology
• Clinical Toxicology
• Immunology

Background:

• Bothrops snakebites are a significant public health concern in Brazil.
• Effective antivenom therapy is crucial for managing Bothrops envenomation.
• Hospital Vital Brazil-Instituto Butantan (HVB-IB) is a key center for snakebite treatment and research.

Purpose of the Study:

• To compare the efficacy of different antivenom dosages for Bothrops snakebites.
• To evaluate clinical outcomes and envenoming manifestations in patients receiving varying antivenom treatments.
• To assess the impact of antivenom neutralization capacity on patient recovery.

Main Methods:

• Retrospective study of 730 Bothrops snakebite cases treated at HVB-IB.
• Comparison of two patient groups (411 in 1983/84, 319 in 1986) receiving different average antivenom neutralization doses (215 mg vs. 117 mg).
• Analysis of patient demographics, bite characteristics, treatment details, and clinical evolution, including local envenoming and coagulation impairment.

Main Results:

• No significant differences were observed between groups regarding patient sex, age, bite location, or pre-hospital interventions (incision, tourniquet).
• The time from bite to hospital admission and the classification of Bothrops jararaca (young/adult) were similar across groups.
• Both groups exhibited comparable evolution of local envenoming manifestations and coagulation impairment, with no reported deaths.

Conclusions:

• The study suggests that lower doses of antivenom may be as effective as higher doses in managing Bothrops snakebites, given similar clinical outcomes.
• Factors such as prompt medical attention and inherent snake venom properties might play a more significant role than antivenom dose variations in this context.
• Further prospective studies are warranted to definitively establish optimal antivenom dosing strategies for Bothrops envenomation.