title: A comparison of serum antivenom concentrations after intravenous and intramuscular administration of redback (widow) spider antivenom.
abstract: OBJECTIVE
  There are no studies measuring antivenom concentrations following intramuscular administration. This study aimed to compare antivenom concentrations following intravenous and intramuscular administration of redback spider antivenom (RBSAV).
  
  
  METHODS
  Twenty patients recruited to a controlled trial comparing intramuscular and intravenous administration of antivenom had serial blood samples collected at 30 min intervals for 2 h after the administration of one or two doses of antivenom. Antivenom concentration was measured using an enzyme immunoassay.
  
  
  RESULTS
  Ten patients received intramuscular antivenom but antivenom could not be detected in serum after either one or two vials, at any time point. The median time of the final sample after commencement of antivenom treatment in these patients was 3.2 h (1.8-5 h). Ten patients received intravenous antivenom (three one vial and seven two or more vials) and antivenom was detected in all patients.
  
  
  CONCLUSIONS
  RBS AV given by the intramuscular route is unlikely to be effective in the treatment of redback (widow) spider bite.
authors.affiliation: Tropical Toxinology Unit, Menzies School of Health Research, Charles Darwin University, Darwin, Australia. geoffrey.isbister@menzies.edu.au
authors.forename: Geoffrey K
authors.initials: GK
authors.lastname: Isbister
authors.forename: Margaret
authors.initials: M
authors.lastname: O'Leary
authors.forename: Mark
authors.initials: M
authors.lastname: Miller
authors.forename: Simon G A
authors.initials: SG
authors.lastname: Brown
authors.forename: Sharmaine
authors.initials: S
authors.lastname: Ramasamy
authors.forename: Rosemary
authors.initials: R
authors.lastname: James
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Schneider
mesh_terms: D000328:Adult; D000818:Animals; D000997:Antivenins / Q000008:administration & dosage* / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D001098:Spider Bites / Q000188:drug therapy*; D013111:Spider Venoms / Q000037:antagonists & inhibitors*
chemical_list: D000997:Antivenins; D013111:Spider Venoms