INCIDENCE AND SAFETY PROFILE OF POLYVALENT ANTIVENOM IN HEMOTOXIC AND NEUROTOXIC SNAKEBITE VICTIMS: A TERTIARY CARE EXPERIENCE
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Keywords
snake bite, Adverse drug reaction, anti-snake venom, haemotoxic envenomation, neurotoxic envenomation
Abstract
Snakebite envenoming remains a significant public health concern, particularly in tropical and subtropical regions. Hemotoxic and neurotoxic envenomation present unique clinical challenges, with anti-snake venom (ASV) being the primary treatment. However, adverse drug reactions (ADRs) to ASV, though rare, can range from mild allergic responses to severe complications such as anaphylaxis and renal failure. Underreporting of ADRs further complicates pharmacovigilance efforts, particularly in India. This study aims to estimate the incidence of ADRs in ASV-treated patients with hemotoxic and neurotoxic envenomation, compare the frequency and spectrum of ADRs between envenomation types, and assess ASV safety profiles across three manufacturers. This study is a prospective, observational, multicentre study which was conducted from January 2023 to December 2024 across two government secondary care centers (Perambalur and Ariyalur) and a private hospital in Erode. Data collection included demographics, envenomation classification, ASV details (manufacturer, batch number, dosing), and ADR documentation. The results among the 476 snakebite cases, Perambalur accounted for 77.73%, highlighting a localized risk factor. Laborers were the predominant victims (71.9%), with peak incidence observed between August and November. Of 206 ASV-treated patients, 55 (26.7%) experienced ADRs, with haemotoxic envenomation cases showing the highest incidence (27.08%). Notably, females exhibited a higher ADR rate (31.1%). Lack of pre-hospital intervention was associated with a significant increase in ADRs (28.4%). Patients requiring higher ASV doses (11–20 vials) had a greater likelihood of adverse events, particularly in haemotoxic (40.7%) and neurotoxic (55%) envenomation cases. The conclusion of the study is to underscores the necessity for enhanced pharmacovigilance, early intervention, and optimized ASV administration to mitigate ADR risks. Geographic variations, envenomation types, and manufacturer differences necessitate further investigation to refine treatment protocols and improve patient outcomes.
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Deva kumar.K
Assistant professor, Department of Pharmacology, A.C.S medical college and hospital, affiliated to Dr.M.G.R educational and research institute, Chennai, Tamilnadu, India.
Sumetha suga.D
Associate professor, Department of Microbiology, A.C.S medical college and hospital, affiliated to Dr.M.G.R educational and research institute. Chennai, Tamilnadu, India.
Selvalaxmi .G
Associate professor, Department of Pharmacology, Bhaarath Medical College and Hospital, Bharath institute of higher education and research. Chennai, Tamilnadu, India
Sri devi S.A
Professor, Department of Pharmacology, A.C.S medical college and hospital, affiliated to Dr.M.G.R educational and research institute. Chennai, Tamilnadu, India.