Pharmacotherapeutic study of efficacy, safety and prognostic analysis of anti snake venom serum in snake bite patients

Abstract

Background: Snakebite is a common medical emergency especially in the rural areas. The effective measure to treat most of the manifestations of venomous snake bite is timely administration of anti-snake venom serum (ASVS). Problems associated with ASVS use are lack of evidence for optimal dose schedule and occurrence of hypersensitivity reactions.Methods: A retrospective review of snakebite cases was carried out from record section of a tertiary care teaching hospital from January 2011 to December 2011.Results: Out of total 202 snakebite patients admitted during the study period, age group of 21-30 years (mainly male victims) accounted for highest no. of snakebite cases (25.7%). The mean (±SD) dose of ASVS used was 124 (±112) mL. 11.8% patients had suffered from adverse drug reactions due to ASVS. 7.4% patients required mechanical ventilation. Overall mortality in our study was 9.4%. Mortality was higher (50%) where the time interval between the snakebite and initiation of treatment was >6 hours. Out of total 15 patients who required mechanical ventilation, n=10 (66.6%) patient died.Conclusions: In our study, mean dose of ASVS used was as per WHO guidelines. Less incidence of adverse drug reaction due to ASVS may be because of co-administration of corticosteroids and anti-histaminics. Delay in getting treatment with ASVS, neurotoxic envenomation and respiratory failure, were the risk factors associated with adverse prognosis due to snake bite in our set up.