How common are antivenom-related complications in snakebite treatment?

Updated: Apr 09, 2021
  • Author: Spencer Greene, MD, MS, FACEP, FACMT, FAAEM; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

In a meta-analysis of 11 studies, Schaeffer et al reported an 8% incidence of acute adverse reactions following FabAV use. [73] Data from the North American Snakebite Registry indicated that only 2.3% of adults and 2.7% of children who received FabAV had acute adverse reactions, including rash (0.9%), hypotension (0.9%), and bronchospasm (0.9%). [74] Finally, in a study of 1,340 patients treated with FabAV in Arizona, the incidence of acute adverse reactions was 1.4%. [75] None was serious enough to require discontinuation. Serum sickness was reported in 13% of patients in the meta-analysis. Serum sickness from FabAV was not observed in the other studies.

There are no studies that specifically measure the incidence of adverse reactions following F(ab’)2AV use. The package insert cites an incidence of 76%, including pruritus (43%) and rash (12%). In a randomized clinical trial comparing F(ab’)2AV to FabAV, the incidences of pruritus and rash were 42.5% and 12.5%, respectively, in the F(ab’)2AV group. [76]


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