Improving Safety of Antivenom in People Bitten by Snakes

Summary

A study to increase the safety of polyvalent antivenom involving 1000 patients in three centres: low dose adrenaline, promethazine, \& hydrocortisone (alone and in combination) to prevent acute adverse reactions to antivenom in people bitten by snakes: randomised, double blind, placebo-controlled trial.

Timeline

Start

2005-03

Primary completion

2008-04

Completion

2008-04

Outcome

Mixed primary results

paper Compared with placebo, adrenaline significantly reduced severe reactions to antivenom by 43% (95% CI 25-67) PMID 21572992 ↗

paper hydrocortisone and promethazine did not. PMID 21572992 ↗

Publications

• de Silva HA, Pathmeswaran A, Ranasinha CD, Jayamanne S, Samarakoon SB, Hittharage A, Kalupahana R, Ratnatilaka GA, Uluwatthage W, Aronson JK, Armitage JM, Lalloo DG, de Silva HJ. Low-dose adrenaline, promethazine, and hydrocortisone in the prevention of acute adverse reactions to antivenom following snakebite: a randomised, double-blind, placebo-controlled trial. PLoS Med. 2011 May;8(5):e1000435. doi: 10.1371/journal.pmed.1000435. Epub 2011 May 10.

Drugs

Evaluation	Drug	Modality	Dose	Route
Subject	Epinephrine	Other / unclassified	0.25 ml	Subcutaneous
Subject	Hydrocortisone	Other / unclassified	200 mg	Intravenous
Subject	Promethazine	Small molecule	25 mg	Intravenous

Indications