Division of Medical Toxicology, United States of America; Department of Emergency Medicine, East Carolina University, Greenville, NC 27858, United States of America.
Department of Emergency Medicine, East Carolina University, Greenville, NC 27858, United States of America.
Am J Emerg Med. 2023 Nov;73:17-19. doi: 10.1016/j.ajem.2023.08.010. Epub 2023 Aug 8.
The definitive treatment of North American crotalid snakebites is antivenin. In 2000, an FabAV antivenom (CroFab®) was introduced and in 2022, F(ab')AV (Anavip®) was approved for treatment of copperhead bites. Our center that sees primarily copperhead snake bites added the recently approved treatment as a second option for the 2022 snake bite season. This brief report we describe our initial experience with the two antivenins via retrospective chart review: the cost, charge, laboratory differences, response to therapy, complications and duration of hospitalization of admitted patients with copperhead envenomation. Using three independent reviewers in this IRB exempt report we found 31 patients with copperhead bites (7 exclusions) leaving 19 adults and 7 children for analysis. We found there was no difference in age, sex, presence of lab abnormalities, total vials administered, or length of stay. There was significant differences in hospital costs and charges to the patient. Future research should include multi-center experiences comparing the two antivenins.
北美的响尾蛇咬伤的确定性治疗方法是抗蛇毒血清。2000 年,一种 FabAV 抗蛇毒血清(CroFab®)问世,2022 年,F(ab')AV(Anavip®)被批准用于治疗响尾蛇咬伤。我们中心主要治疗响尾蛇咬伤,在 2022 年的蛇咬伤季节增加了最近批准的治疗方法作为第二种选择。本简要报告通过回顾性图表审查描述了我们使用两种抗蛇毒血清的初步经验:成本、费用、实验室差异、对治疗的反应、并发症以及住院时间。在这项 IRB 豁免报告中,我们使用了三名独立的审查员,发现 31 例响尾蛇咬伤(7 例排除),19 例成人和 7 例儿童符合分析条件。我们发现,年龄、性别、实验室异常存在、使用的总瓶数或住院时间均无差异。但患者的住院费用和费用存在显著差异。未来的研究应包括比较两种抗蛇毒血清的多中心经验。