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Introduction: In 2018, Anavip became available for the treatment of rattlesnake envenomations in the USA. No comparisons between the treatment characteristics of patients have been made since Anavip and CroFab have both been widely available. The objective of this study was to compare the number of antivenom vials administered of CroFab and Anavip during the treatment of rattlesnake envenomations in the USA.
Methods: This was a secondary analysis of rattlesnake envenomations utilizing the North American Snakebite Registry (NASBR) from 2019 through 2021. Frequencies and proportions were used to summarize demographics and baseline clinical characteristics. The primary outcome was total antivenom vials administered during treatment. Secondary outcomes included the number antivenom administration events, total treatment time, and hospital length of stay.
Results: Two hundred ninety-one rattlesnake envenomations were analyzed; most occurred in the Western USA (n = 279, 96 %). One hundred one patients (35%) received only CroFab, 110 (38%) received Anavip only, and 80 (27%) received both products. The median number of vials used was 10 for CroFab, 18 for Anavip, and 20 for both antivenoms. More than one antivenom administration was necessary in thirty-nine (39%) patients that received only CroFab and 76 (69%) patients that received Anavip only. The median total treatment time was 5.5 hours for CroFab, 6.5 for Anavip, and 15.5 hours when both antivenoms were administered. All antivenom groups had a median hospital length of stay of 2 days.
Conclusions: Rattlesnake envenomated patients in the Western USA treated with CroFab had fewer antivenom vials and fewer antivenom administrations compared to patients treated with Anavip.
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http://dx.doi.org/10.1007/s13181-023-00941-7 | DOI Listing |
J Med Toxicol
September 2025
Department of Emergency Medicine, LSU Health Shreveport, 1501 Kings Highway, PO Box 33932, Shreveport, LA, 71130-3932, USA.
Introduction: Copperheads and cottonmouths are responsible for most snake envenomations in Louisiana. While the United States Food and Drug Administration has approved both Crotalidae polyvalent immune Fab (FabAV) and Crotalidae immune F(ab') (Fab2AV) for Agkistrodon envenomations, data is limited comparing their efficacies for this indication.
Methods: This is a retrospective study comparing FabAV to Fab2AV in the treatment of suspected Agkistrodon envenomations in Louisiana between April 2017 and October 2024.
Trop Med Infect Dis
August 2025
Faculty of Applied Health Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada.
A review was conducted on snakebites in Central America. Information was extracted using the databases of PubMed, SciELO, and LILACS. Information included retrospective studies, case reports, and case series; in this way, valuable information was retrieved from limited sources.
View Article and Find Full Text PDFPLoS Negl Trop Dis
August 2025
Laboratório de Imunopatologia, Instituto Butantan, São Paulo, Brazil.
Background: Phenotypic polymorphism in rattlesnake venoms is well-documented, with a dichotomy between hemorrhagic (Type I) and neurotoxic (Type II) venoms. In South America, the Type II phenotype is predominant; however, evidence of Type I venom in Crotalus durissus ruruima raises concerns about the efficacy of the Crotalus antivenom, which is prepared only with Type II venoms. Consequently, the Bothrops-Crotalus antivenom has been proposed as an alternative treatment for envenomation by Type I venoms.
View Article and Find Full Text PDFAm J Vet Res
July 2025
Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL.
Objective: To characterize coagulopathies before and after antivenom administration in rattlesnake-envenomated equids.
Methods: Client-owned envenomated equids treated with antivenom at Colorado State University (2023 to 2024). Rattlesnake bite severity score (RBSS), platelet count, prothrombin time, activated thromboplastin time, D-dimers, antithrombin, and viscoelastic testing variables were assessed before and after antivenom administration.
Toxicon
October 2025
Laboratório de Proteômica e Aracnídeos-Fundação Ezequiel Dias, Brazil. Electronic address:
The antivenom plays a crucial role in the targeted treatment of snakebite envenomation and it is produced from pools of venoms, whose composition can be influenced by factors such as diet, sexual dimorphism, ontogeny, mutations, and geographical distribution. This study aimed to compare the compositions of venom pools used in antivenom production. Three distinct pools of venoms from Crotalus durissus snakes, employed in horse immunization, were analyzed using a multifaceted approach, including liquid chromatography, enzymology, immunology, and proteomic analysis.
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