• acute care
• envenomation
• tropical medicine
• safety

The stability of antivenoms has been the subject of numerous studies. A recent review of the literature highlights the convergence of these studies demonstrating the efficacy and safety of expired antivenoms.1 However, as the authors point out, the results do not come from randomised clinical trials, which alone could validate the use of expired antivenoms without loss of opportunity for the patient.

They addressed the urgent issue of access to antivenoms in low-income countries, and the use of expired antivenoms to alleviate shortages. The antivenom access crisis, particularly in sub-Saharan Africa, is a human and economic disaster.2 3 First, the low availability of antivenoms, particularly in Africa, is the result of a combination of factors that cannot be addressed by using expired antivenoms, if only because their price will not fall due to the need to replenish stocks.3 Second, the recommendations aimed at justifying the use of expired antivenoms are debatable. How can we be sure of the validity of an expired product? Do we have sufficient guarantees that it has been stored under appropriate conditions? How long will it remain effective and, …