Post Marketing evaluation of Anti Snake Venom (ASV) administered as a standard treatment for snakebite. Experience from western India

Aim: To study the safety profile and effectiveness of Anti Snake venom (ASV) in western India Methods: This retrospective study gathered safety, epidemiological and clinical data on 157 snake bite patients admitted at Shri Sainath Hospital, in Dharampur, Gujarat, from July 2022 to February 2023. Results: Majority of the bites occurred between August and November. There were 88 males between 5 and 70 yrs. (mean 39.14 yrs.), 69 females between 2 and 70 years (mean 40.32 yrs.). 6 of these were children ranging from 2 to 12 years.134 were agricultural labourers. 120 cases were analysable. 17 had neurotoxicity and 103 had haemotoxicity. Mean (SD) number of vials used was 10.1(6.2), time to discontinue ASV was 3.0(5.2) hours, and duration of hospital stay was 4.5(2.6) days. Patients bitten by saw scaled vipers were discharged early. In Russel’s Viper bites, number of vials used, was higher if the bite to needle time was less than 6 hours 9 patients suffered 24 adverse events, with two possible cases of anaphylaxis. One case had urticaria, itching and tachycardia as a triad. The remaining were isolated events of mild urticaria, itching, tachycardia, hypotension, cough, rigor. Conclusion: All cases were successfully managed with no fatalities or severe comorbidities. Adverse events were reported in 5.7% cases. Mean of 10.1 vials were needed for control of envenomation, a number much less that national guidelines. The ASV brand used was well tolerated. Patients who were brought late suffered more renal complications