A RANDOMIZED BLINDED COMPARISON OF 2 DOSES OF ANTIVENOM IN THE TREATMENT OF BOTHROPS ENVENOMING IN SAO-PAULO, BRAZIL

An earlier study in Sao Paulo state suggested that the dose for patien ts with mild or moderate envenoming by Bothrops snakes (mainly Bothrop s jararaca) could be effectively decreased to 4 ampoules (40 mL) of Br azilian Bothrops polyspecific antivenom. The present 'blinded' study e xamined the lowest dose studied in the first trial (equivalent to 4 x 10 mL ampoules) and half that dose of antivenom (equivalent to 2 x 10 mL ampoules) in 2 similar groups of 170 patients who were comparable i n all respects before treatment. The majority of patients showed rapid clinical improvement after treatment with either dose regimen and rap id restoration of blood coagulability and cessation of bleeding. There was no apparent difference between the 2 groups of patients in any re spect. The study confirmed that, in such patients, the dose of antiven om can be decreased from 4 ampoules to 2 ampoules without reduction of therapeutic efficacy and it is highly likely that this reduction will result in a decrease of early anaphylactic reactions caused by the an tivenom.