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Crotaline Fab antivenom for the treatment of children with rattlesnake envenomation.
Pediatrics. 2002 Nov; 110(5):968-71.Ped

Abstract

OBJECTIVE

There is little data regarding safety or efficacy of Crotalinae polyvalent immune Fab (ovine) antivenom (crotaline Fab) in pediatric patients. Our objective was to provide the first information regarding safety and effectiveness of this new drug in children.

METHODS

Data were collected prospectively and retrospectively for all consecutive pediatric patients bitten by rattlesnakes and treated at 2 urban hospitals during 2001. Cases were included if there were signs of envenomation at presentation, patient age was 13 years or less, and there was administration of crotaline Fab. Cases were excluded if antivenin (Crotalidae) polyvalent (equine origin, the conventional antivenom) was given. Primary outcome variables were snakebite severity scores throughout the course of therapy, number of vials of crotaline Fab administered, occurrence of allergic reactions, adjunct surgical therapy, and the presence of permanent sequelae or serum sickness identified at follow-up.

RESULTS

In the 12 cases studied, ages ranged from 14 months to 13 years (mean: 6.9; standard deviation: 4.2). Presentation snakebite severity scores ranged from 2 to 9 (mean: 5.3; standard deviation: 2.3). Total crotaline Fab doses ranged from 4 to 22 vials (mean: 12.7; standard deviation: 5.4). Initial control of symptoms was achieved with 4 to 16 vials (mean: 7.7; standard deviation: 3.7), and severity scores stabilized or improved within 24 hours in all patients. Recurrence of local swelling occurred in 1 case despite scheduled repeat doses of antivenom. No cases required surgical intervention, and no permanent sequelae were identified. No immediate or delayed hypersensitivity reactions occurred.

CONCLUSION

In this group of pediatric patients treated for rattlesnake envenomation, crotaline Fab antivenom was safe and seemed to be effective.

Authors+Show Affiliations

Offerman SR
Division of Medical Toxicology, Department of Emergency Medicine UCSD Medical Center, San Diego, California, USA.
Bush SP
No affiliation info available
Moynihan JA
No affiliation info available
Clark RF
No affiliation info available

MeSH

AdolescentAntiveninsChildChild, PreschoolCrotalid VenomsFemaleHumansImmunoglobulin Fab FragmentsImmunoglobulin FragmentsInfantMalePoison Control CentersProspective StudiesRetrospective StudiesSeverity of Illness IndexSnake BitesTreatment OutcomeUnited States

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12415038

Citation

Offerman, Steven R., et al. "Crotaline Fab Antivenom for the Treatment of Children With Rattlesnake Envenomation." Pediatrics, vol. 110, no. 5, 2002, pp. 968-71.
Offerman SR, Bush SP, Moynihan JA, et al. Crotaline Fab antivenom for the treatment of children with rattlesnake envenomation. Pediatrics. 2002;110(5):968-71.
Offerman, S. R., Bush, S. P., Moynihan, J. A., & Clark, R. F. (2002). Crotaline Fab antivenom for the treatment of children with rattlesnake envenomation. Pediatrics, 110(5), 968-71.
Offerman SR, et al. Crotaline Fab Antivenom for the Treatment of Children With Rattlesnake Envenomation. Pediatrics. 2002;110(5):968-71. PubMed PMID: 12415038.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Crotaline Fab antivenom for the treatment of children with rattlesnake envenomation. AU - Offerman,Steven R, AU - Bush,Sean P, AU - Moynihan,James A, AU - Clark,Richard F, PY - 2002/11/5/pubmed PY - 2003/1/17/medline PY - 2002/11/5/entrez SP - 968 EP - 71 JF - Pediatrics JO - Pediatrics VL - 110 IS - 5 N2 - OBJECTIVE: There is little data regarding safety or efficacy of Crotalinae polyvalent immune Fab (ovine) antivenom (crotaline Fab) in pediatric patients. Our objective was to provide the first information regarding safety and effectiveness of this new drug in children. METHODS: Data were collected prospectively and retrospectively for all consecutive pediatric patients bitten by rattlesnakes and treated at 2 urban hospitals during 2001. Cases were included if there were signs of envenomation at presentation, patient age was 13 years or less, and there was administration of crotaline Fab. Cases were excluded if antivenin (Crotalidae) polyvalent (equine origin, the conventional antivenom) was given. Primary outcome variables were snakebite severity scores throughout the course of therapy, number of vials of crotaline Fab administered, occurrence of allergic reactions, adjunct surgical therapy, and the presence of permanent sequelae or serum sickness identified at follow-up. RESULTS: In the 12 cases studied, ages ranged from 14 months to 13 years (mean: 6.9; standard deviation: 4.2). Presentation snakebite severity scores ranged from 2 to 9 (mean: 5.3; standard deviation: 2.3). Total crotaline Fab doses ranged from 4 to 22 vials (mean: 12.7; standard deviation: 5.4). Initial control of symptoms was achieved with 4 to 16 vials (mean: 7.7; standard deviation: 3.7), and severity scores stabilized or improved within 24 hours in all patients. Recurrence of local swelling occurred in 1 case despite scheduled repeat doses of antivenom. No cases required surgical intervention, and no permanent sequelae were identified. No immediate or delayed hypersensitivity reactions occurred. CONCLUSION: In this group of pediatric patients treated for rattlesnake envenomation, crotaline Fab antivenom was safe and seemed to be effective. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/12415038/Crotaline_Fab_antivenom_for_the_treatment_of_children_with_rattlesnake_envenomation_ DB - PRIME DP - Unbound Medicine ER -