1.The Prevalence of Hypersensitivity Reactions to Snake Antivenoms Administered in Sultanah Nur Zahirah Hospital From 2013 To 2016
Nur Aizahakiki Shafie ; Hamid Fauzi ; Mohd Shahezwan Abd Wahab ; Mohd Zaki Fadzil Senek ; Ahmad Khaldun Ismail
The Medical Journal of Malaysia 2020;75(3):216-220
Introduction: Snakebite is an important medical emergency.
Antivenoms remain the only proven treatment for snake
envenoming. However, the use of antivenom is associated
with hypersensitivity reactions. The aims of this study were
to determine the prevalence and types of hypersensitivity
reactions and types and outcomes of pharmacological and
non-pharmacological treatments for antivenom reactions
among snakebite patients that received antivenoms.
Methods: This was a 4-year cross-sectional study of
snakebite patients from January 2013 to December 2016 in
Hospital Sultanah Nur Zahirah (HSNZ), Terengganu. Data
was extracted from the Pharmacy Record on the usage of
antivenom and patients of snakebites treated with
antivenom were identified. Data of patients were then
obtained from the electronic medical records.’ Demographic
details, clinical features and characteristics of antivenom
reactions of patients were recorded in standardized data
collection forms and analyzed using chi-square or MannWhitney U tests.
Results: Of the 44 patients who received antivenom, 24
(54.5%) developed hypersensitivity reaction. All patients
developed reaction early. No patient developed delayed
(serum-sickness) reaction. Of the 24 patients, 14 (58.3%) had
moderate to severe hypersensitivity reaction and 9 (37.5%)
patients had mild reactions. Only one (4.2%) patient
presented with bradycardia.
Conclusion: The prevalence of early hypersensitivity
reaction to snake antivenom in HSNZ was relatively high.
Healthcare providers should be aware of the appropriate
method of preparing and administering antivenom, and the
management for acute hypersensitivity reactions. This will
optimize the management of snakebite and ensure patient
safety