High-Dose Anti-Snake Venom Versus Low Dose Anti-Snake Venom in The Treatment of Poisonous Snake Bites

摘要

Objectives : To asses the optimum dose of anti-Snake venom to treat snake bite cases effectively.This is particularly relevant in the present scenario when the cost of anti-snake venom [BHARAT SERUM PHARMACEUTICALS] has gone upto nearly Rs.500 per vial and the cross-section of people usually affected belong to the poor socioeconomic class. Methodology : SIXTY snake bite cases with envenomation, irrespective of whether they were bitten by Krait,Cobra or very rarely Viper brought within 24 hrs of the bite to DARBHANGA MEDICAL COLLEGE & HOSPITAL LAHERIASARAI, DARB.HANGA.BIHAR State during the 12 months from October 2012 to September 2013 were randomized into two groups of 30 cases each,irrespective of the severity of the cases.One group received a fixed dose regime of Five vials of anti-snake venom and the other Ten vials of the same. Results : In the low dose group there were 3 deaths giving a mortality rate of 10%, Six ( 20%) required dialysis and Two (6.67%) required ventilatory support. In the high dose group there were 4 deaths giving a mortality rate of 13.33%,Nine (30%) required dialysis and Two (6.67%) required ventilatory support.The average hospital stay for the low dose group was 7 days while that of high dose group was 8 days. Conclusion : While there was no additional advantage in following a high-dose regime for snake bite cases,there was considerable financial gain by following the low-dose regime, Most of the parameters showed a beneficial trend for the low- dose group, though the differences were not statistically significant.