PRELIMINARY EVALUATION OF VIPERA-PALAESTINAE SNAKE BITE TREATMENT IN ACCORDANCE TO THE SEVERITY OF THE CLINICAL SYNDROME

The intravenous administration of a 60 ml dose of Vipera palaestinae a ntivenin was the suggested standard treatment of every bitten patient. In this study 85 Vipera, a palestinae bitten patients where selective ly treated with antivenin depending on the severity of the clinical pi cture. Patients who developed systemic or severe local signs received 20 ml of antivenin over 30 min. If symptoms were still present, an add itional 10 ml of antivenin was given until systemic signs subsided. Re peated doses of 10 ml of antivenin was administered in each case of sy stemic symptom relapse. 49% of patients did not exhibit any systemic s ymptoms and did not receive antivenin treatment. In 63% of antivenin t reated cases symptoms were aborted by a single dose of 20 ml of antive nin. 23% of the antivenin treated patients needed 30-40 ml, 19 needed 50-60 ml and only 1 patient (2%) received 80 ml of drug. Serum sicknes s complications were found in 44% of antivenin treated patients. The r esults of this study show that antivenin treatment based on systemic s ymptoms is effective, required less antivenin than the treatment with fixed dose for each patient and reduces the incidence of serum sicknes s. (C) 1998 Elsevier Science Ltd. All rights reserved.