title: Snake antivenom for snake venom induced consumption coagulopathy.
abstract: BACKGROUND
  Snake venom induced consumption coagulopathy is a major systemic effect of envenoming. Observational studies suggest that antivenom improves outcomes for venom induced consumption coagulopathy in some snakebites and not others. However, the effectiveness of snake antivenom in all cases of venom induced consumption coagulopathy is controversial.
  
  
  OBJECTIVE
  To assess the effect of snake antivenom as a treatment for venom induced consumption coagulopathy in people with snake bite.
  
  
  METHODS
  The search was done on 30 January 2015. We searched the Cochrane Injuries Group's Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), Embase Classic+Embase (OvidSP), three other sources, clinical trials registers, and we also screened reference lists.
  
  
  METHODS
  All completed, published or unpublished, randomised, controlled trials with a placebo or no treatment arm, where snake antivenom was administered for venom induced consumption coagulopathy in humans with snake bites.
  
  
  METHODS
  Two authors reviewed the identified trials and independently applied the selection criteria.
  
  
  RESULTS
  No studies met the inclusion criteria for this review.
  
  
  CONCLUSIONS
  Randomised placebo-controlled trials are required to investigate the effectiveness of snake antivenom for clinically relevant outcomes in patients with venom induced consumption coagulopathy resulting from snake bite. Although ethically difficult, the routine administration of a treatment that has a significant risk of anaphylaxis cannot continue without strong evidence of benefit.
authors.affiliation: School of Medicine and Public Health, University of Newcastle, C/O Calvary Mater Newcastle, Waratah, NSW, Australia, 2294.
authors.forename: Kalana
authors.initials: K
authors.lastname: Maduwage
authors.forename: Nick A
authors.initials: NA
authors.lastname: Buckley
authors.forename: H Janaka
authors.initials: HJ
authors.lastname: de Silva
authors.forename: David G
authors.initials: DG
authors.lastname: Lalloo
authors.forename: Geoffrey K
authors.initials: GK
authors.lastname: Isbister
mesh_terms: D000997:Antivenins / Q000627:therapeutic use*; D004211:Disseminated Intravascular Coagulation / Q000209:etiology / Q000628:therapy*; D006801:Humans; D012910:Snake Venoms / Q000506:poisoning*
chemical_list: D000997:Antivenins; D012910:Snake Venoms