Adverse Events Following Equine Rabies Immunoglobulin Administration among Category 3 Animal Bite Exposures

Abstract Introduction: Rabies is known to be 100% fatal. Equine rabies immunoglobulin (ERIG) recipients are prone to hypersensitivity reactions following administration. This study aims to estimate the adverse events following ERIG among category 3 animal exposures reported in a tertiary care centre in Kerala during the year 2022. Materials and Methods: A record-based descriptive study. Results: Among the 1504 cases, 557 (37.03%) developed sensitivity following the test dose of ERIG, of which 478 were administered with a full dose of ERIG after desensitisation. Human rabies immunoglobulin was given to 26 patients, and monoclonal antibodies were given to 53 patients. Among 1425 who received a full dose of ERIG, 21 (1.5%) developed sensitivity reaction during the observation period, of which 14 had developed sensitivity to the test dose. Of the 21 who developed sensitivity to full dose, 18 patients required only symptomatic management while 3 patients required admission. Conclusion: Testing for sensitivity to test dose will help to identify those in need of premedication with anti-allergic drugs, thereby reducing the risk of hypersensitivity to full dose of ERIG.