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Acute hypersensitivity reactions associated with administration of crotalidae polyvalent immune Fab antivenom.
Ann Emerg Med. 2008 Apr; 51(4):407-11.AE

Abstract

STUDY OBJECTIVE

Acute hypersensitivity reactions are well known to occur with the administration of the Antivenin (Crotalidae) Polyvalent (Wyeth Laboratories, Marietta, PA). Crotalidae polyvalent immune Fab (ovine) (CroFab; FabAV, Protherics, Inc., Brentwood, TN) was introduced in 2001, and early studies reported a hypersensitivity reaction rate up to 19%. We describe the incidence of acute hypersensitivity reactions to FabAV in patients bitten by rattlesnakes.

METHODS

This was a nonconcurrent observational cohort study, with data obtained by chart review of all patients admitted to our service for rattlesnake bites from July 2000 to June 2004. The study was conducted at an urban Level I trauma center and urban children's hospital. All patients treated with FabAV were included. Those who received no antivenom or who were treated with Antivenin (Crotalidae) Polyvalent were excluded. The main outcome variable was whether an acute hypersensitivity reaction developed.

RESULTS

Ninety-three patients were included in the review (72 male and 21 female patients). The mean age was 34.5 years (range 16 months to 91 years), and the mean dose of antivenom was 12 vials (range 4 to 32 vials). The incidence of acute hypersensitivity reactions was 5 of 93, or 5.4%. Four patients developed a mild reaction that was easily treated and were able to finish the full course of antivenom. Only 1 patient developed a reaction that prevented further antivenom administration.

CONCLUSION

FabAV appears to be associated with a lower incidence of acute hypersensitivity than initially reported. Most reactions are mild and easily treated and do not preclude further dosing of antivenom.

Authors+Show Affiliations

Department of Medical Toxicology, Banner Good Samaritan Medical Center, Phoenix, AZ, USA. cannonrd@upmc.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18191286

Citation

Cannon, Robert, et al. "Acute Hypersensitivity Reactions Associated With Administration of Crotalidae Polyvalent Immune Fab Antivenom." Annals of Emergency Medicine, vol. 51, no. 4, 2008, pp. 407-11.
Cannon R, Ruha AM, Kashani J. Acute hypersensitivity reactions associated with administration of crotalidae polyvalent immune Fab antivenom. Ann Emerg Med. 2008;51(4):407-11.
Cannon, R., Ruha, A. M., & Kashani, J. (2008). Acute hypersensitivity reactions associated with administration of crotalidae polyvalent immune Fab antivenom. Annals of Emergency Medicine, 51(4), 407-11. https://doi.org/10.1016/j.annemergmed.2007.09.036
Cannon R, Ruha AM, Kashani J. Acute Hypersensitivity Reactions Associated With Administration of Crotalidae Polyvalent Immune Fab Antivenom. Ann Emerg Med. 2008;51(4):407-11. PubMed PMID: 18191286.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute hypersensitivity reactions associated with administration of crotalidae polyvalent immune Fab antivenom. AU - Cannon,Robert, AU - Ruha,Anne-Michelle, AU - Kashani,John, Y1 - 2008/01/11/ PY - 2007/03/13/received PY - 2007/08/16/revised PY - 2007/09/28/accepted PY - 2008/1/15/pubmed PY - 2008/5/7/medline PY - 2008/1/15/entrez SP - 407 EP - 11 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 51 IS - 4 N2 - STUDY OBJECTIVE: Acute hypersensitivity reactions are well known to occur with the administration of the Antivenin (Crotalidae) Polyvalent (Wyeth Laboratories, Marietta, PA). Crotalidae polyvalent immune Fab (ovine) (CroFab; FabAV, Protherics, Inc., Brentwood, TN) was introduced in 2001, and early studies reported a hypersensitivity reaction rate up to 19%. We describe the incidence of acute hypersensitivity reactions to FabAV in patients bitten by rattlesnakes. METHODS: This was a nonconcurrent observational cohort study, with data obtained by chart review of all patients admitted to our service for rattlesnake bites from July 2000 to June 2004. The study was conducted at an urban Level I trauma center and urban children's hospital. All patients treated with FabAV were included. Those who received no antivenom or who were treated with Antivenin (Crotalidae) Polyvalent were excluded. The main outcome variable was whether an acute hypersensitivity reaction developed. RESULTS: Ninety-three patients were included in the review (72 male and 21 female patients). The mean age was 34.5 years (range 16 months to 91 years), and the mean dose of antivenom was 12 vials (range 4 to 32 vials). The incidence of acute hypersensitivity reactions was 5 of 93, or 5.4%. Four patients developed a mild reaction that was easily treated and were able to finish the full course of antivenom. Only 1 patient developed a reaction that prevented further antivenom administration. CONCLUSION: FabAV appears to be associated with a lower incidence of acute hypersensitivity than initially reported. Most reactions are mild and easily treated and do not preclude further dosing of antivenom. SN - 1097-6760 UR - https://www.unboundmedicine.com/medline/citation/18191286/Acute_hypersensitivity_reactions_associated_with_administration_of_crotalidae_polyvalent_immune_Fab_antivenom_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-0644(07)01675-7 DB - PRIME DP - Unbound Medicine ER -