ANTIBIOTIC-PROPHYLAXIS FOR PIT VIPER ENVENOMATION - PROSPECTIVE, CONTROLLED TRIAL

The efficacy of prophylactic antibiotics for preventing infectious com plications at the site of pit viper envenomation has not been well stu died, We undertook a prospective, controlled trial of antibiotic treat ment versus no antibiotic treatment among 114 victims of crotalid enve nomation in Ecuador's Amazon rain forest. A group of 59 patients recei ved intravenous gentamicin and chloramphenicol, and 55 patients did no t. All other aspects of care were identical. There were no statistical ly significant differences between antibiotic-treated and untreated pa tients with regard to demographics, delay in treatment, clinical and l aboratory evidence of severity of envenomation, or use of antivenin. N ine abscesses occurred, six in the antibiotic-treated group and three in the untreated group. The results of this study did not show any sta tistically significant differences in outcome in terms of the number o f abscesses that occurred between antibiotic-treated and untreated pat ients. Based on this lack of differences, routine use of prophylactic antibiotics for prevention of infectious complications of crotalid env enomation cannot be recommended.