Use of antivenom for snakebites reported to United States poison centers.
In 2001, a new antivenin was introduced to the United States and became widely available in the snakebite season of 2002. We investigated what impact this may have had on snakebite treatment and medical outcome.


METHODS
The study used a retrospective review of all snakebites to humans reported to the National Poison Center Database System from 2000 to 2007.


RESULTS
During the 8 years, there were 37,760 snakebites, with a mean of 4720 bites per year. There was a 27% increase in bites reported to a Poison center for the 8-year period and an overall 13.5% increase in the use of antivenin. The 2 categories primarily responsible for the increased use of antivenin were copperhead and crotaline-unknown. Rattlesnake bites remained the category most frequently treated with antivenin with a mean 52.5% treatment rate and only moderate increase for the 8 years. There was no change in the percentage or number of patients with a major outcome (mean, 3.8%) or death (mean, 0.5%). There was a decrease in patients with a minor outcome and an increase in patients with a moderate outcome.


CONCLUSIONS
The new antivenin is reported to have a reduced potential for adverse reactions. This may have had a role in the decision of which snakebite victims received antivenin.


CONCLUSIONS
With the introduction of a new antivenin, there has been a dramatic increase in the number of snakebite patients treated with antivenin. This has been most noticeable in snake bite categories that were less frequently treated with antivenin in the past.
Spiller
Henry A
HA
Kentucky Regional Poison Center, PO Box 35070, Louisville, KY 40232-5070, USA. henry.spiller@nortonhealthcare.org
Bosse
George M
GM
Ryan
Mark L
ML
D000818:Animals; D000997:Antivenins / Q000627:therapeutic use*; D002423:Cause of Death; D016009:Chi-Square Distribution; D003435:Crotalid Venoms; D016208:Databases, Factual; D004363:Drug Utilization / Q000706:statistics & numerical data; D004635:Emergency Medicine / Q000458:organization & administration*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007140:Immunoglobulin Fab Fragments; D007128:Immunoglobulin Fragments / Q000627:therapeutic use*; D016014:Linear Models; D008297:Male; D018579:Patient Selection; D011039:Poison Control Centers / Q000458:organization & administration; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D012189:Retrospective Studies; D012909:Snake Bites / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D000997:Antivenins; D003435:Crotalid Venoms; C431183:Crotalidae Polyvalent immune Fab; D007140:Immunoglobulin Fab Fragments; D007128:Immunoglobulin Fragments