title: A randomized 'blinded' comparison of two doses of antivenom in the treatment of Bothrops envenoming in São Paulo, Brazil.
abstract: An earlier study in São Paulo state suggested that the dose for patients with mild or moderate envenoming by Bothrops snakes (mainly Bothrops jararaca) could be effectively decreased to 4 ampoules (40 mL) of Brazilian Brothrops polyspecific antivenom. The present 'blinded' study examined the lowest dose studied in the first trial (equivalent to 4 x 10 mL ampoules) and half that dose of antivenom (equivalent to 2 x 10 mL ampoules) in 2 similar groups of 170 patients who were comparable in all respects before treatment. The majority of patients showed rapid clinical improvement after treatment with either dose regimen and rapid restoration of blood coagulability and cessation of bleeding. There was no apparent difference between the 2 groups of patients in any respect. The study confirmed that, in such patients, the dose of antivenom can be decreased from 4 ampoules to 2 ampoules without reduction of therapeutic efficacy, and it is highly likely that this reduction will result in a decrease of early anaphylactic reactions caused by the antivenom.
authors.affiliation: Hospital Vital Brazil, Instituto Butantan, São Paulo.
authors.forename: M T
authors.initials: MT
authors.lastname: Jorge
authors.forename: J L
authors.initials: JL
authors.lastname: Cardoso
authors.forename: S C
authors.initials: SC
authors.lastname: Castro
authors.forename: L
authors.initials: L
authors.lastname: Ribeiro
authors.forename: F O
authors.initials: FO
authors.lastname: França
authors.forename: M E
authors.initials: ME
authors.lastname: de Almeida
authors.forename: A S
authors.initials: AS
authors.lastname: Kamiguti
authors.forename: I S
authors.initials: IS
authors.lastname: Santo-Martins
authors.forename: M L
authors.initials: ML
authors.lastname: Santoro
authors.forename: J E
authors.initials: JE
authors.lastname: Mancau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000997:Antivenins / Q000008:administration & dosage*; D001777:Blood Coagulation; D017837:Bothrops; D002648:Child; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012909:Snake Bites / Q000097:blood / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000997:Antivenins; D005340:Fibrinogen