Table 1
| Author, date and country | Patient group | Study type (level of evidence) | Outcomes | Key results | Study weaknesses |
|---|---|---|---|---|---|
| De Rezende NA et al, 1995, Brazil | 18 patients with signs of systemic envenomation | Cohort | Serum venom concentrations measured by ELISA before and after intravenous antivenom treatment | Venom antigens cleared 1 hour after antivenom | No serum venom kinetics in a control group not treated with antivenom |
| Antivenom concentrations measured by ELISA before and after intravenous antivenom treatment | High antivenom titres persisted for 24 hours | ||||
| Krifi MN et al, 1999, Tunisia | 147 children under 15 years with grade II and III scorpion envenomation, divided into 6 groups according to whether given 1 or 2 doses of antivenom (IM or IV or IM and IV) and no antivenom | Cohort | Intramuscular administration | No significant effect on toxicokinetic curve or recovery time, when only one dose given | Unclear whether retrospective analysis or prospective study. No apparent blinding |
| Intravenous administration | Rapid clearance of venom and shortened recovery time | ||||
| Ghalim N et al, 2000, Morocco | 275 patients, of which 179 were treated with antivenom. Antivenom administered intramuscularly (77.6%) or subcutaneously (6.2%) or both (16.2%) | Prospective cohort study | Epidemiology of envenomation | 247 showed only grade I symptoms. No patients with grade III symptoms | Venom kinetics not studied in grade II patients as they constituted only 10% of cohort |
| Toxokinetics in grade I envenomation | Reduction in serum venom concentration. Greater effect of 10 ml versus 2–5 ml antivenom | ||||
| Clinical course | Symptoms improved with antivenom | ||||
| Hammoudi-Triki D et al, 2004, Algeria | 182 patients (adults and children) stung by scorpions. Retrospective review of charts and blood results for those treated with intramuscular antivenom | Cohort | Epidemiology | No grade III (severe) envenomations | Retrospective review. Intramuscular rather than intravenous route used. Only one dose of antivenom given. Only 40 patients had post immunotherapy blood samples taken. Venom concentrations lower than in Krifi (1999) and Ghalim (2000) studies, although this may be due to ELISA differences |
| Venom kinetics | 10 ml of intramuscular antivenom did not alter venom kinetics |
