Adverse drug reaction profile of anti-snake venom in a rural tertiary care teaching hospital

Snake bite is a major occupational hazard to farmers, labors especially in rural areas. Majority of the antivenom reactions are wrongly attributed to envenomation. The study was carried out with the aim of evaluation of the adverse drug reaction profile of anti-snake venomserum(ASV) in a rural tertiary care hospital. An observational study was conducted in SRTR Medical College, Ambajogai, Maharashtra, India. A total number of 296 indoor case papers of snake bite from February to September 2011 and June to August 2012 were retrieved from the record section and the antivenom reactions were assessed. In addition, basic epidemiological data andprescribing practices ofASVwere alsoanalyzed.Vasculotoxic snakebitesweremore common (50.61%) than neuroparalytic ones (22.56%).Mild envenomationwas the commonest presentation. Atotal of92(56.10%) patientswho receivedASVsufferedfromantivenomreactions.Themost commonnature of reactionwas chills, rigors (69.56%) followedby nausea and vomiting(34.8%).10-15%patients sufferedfrom moderate to severe reactions like hypotension and sudden respiratory arrest. We did not find any dose response relationship of ASV to risk of reactions (odds ratio 0.37). Intradermal sensitivity testwas performed in about 72% cases. Our study showed a higher incidence of reactions to ASV at our institute.

Key words: Snake bite, Envenoming, Antivenom, Antivenom reactions, Anaphylaxis.