Table 1
Author, date, and countryPatient groupStudy type (level of evidence)OutcomesKey resultsStudy weaknesses
Sofer S et al, 1994, IsraelChildren admitted to PICU after scorpion envenomation. Comparison of 52 children given antivenom between 10 July 1885 and 1 July 1989 and 52 children treated without antivenom between 1 July 1989 and Dec 31 1992CohortDuration of PICU stayNo significant differenceHistorical comparison. Children treated without antivenom may have benefited from improved supportive care
Duration of hospital stayNo significant difference
Full recovery49 in antivenom group, 52 in control group
Death2 in antivenom group, 0 in control group
Belghith M et al, 1999, TunisiaPatients participating in a study on the efficacy of high-dose hydrocortisone after scorpion sting. Matched pair comparison of 135 patients given scorpion antivenom in addition to their trial medicationCohortClinical improvement50% of antivenom group, 64% control groupRetrospective review of patients recruited into another trial. Results not stratified according to hydrocortisone treatment
Prevention of progression of symptoms13% antivenom group, 10% control group
Duration of hospital stayNo significant difference
Death1 in control group
Abroug F et al, 1999, Tunisia825 consecutive patients aged 10 or older presenting to a non-teaching hospital emergency departmentRandomised placebo controlled trial of intravenous scorpion antivenomClinical improvement55% antivenom group, 66% control groupTrial found to be underpowered to show any difference in mortality as mortality was so low
Prevention of symptom progression94% in antivenom group, 96% in control group
Hospital admission13% in antivenom group, 9% in control group
Duration of hospital stayNo significant difference
Death1 in each group
Ghalim N et al, 2000, Morocco275 patients with scorpion envenomation, 179 of whom were treated with antivenom (IM, SC or both routes)Prospective cohortEffectiveness of antivenom according to sting admission intervalAntivenom more effective if sting admission interval <1 hour90% of patients had only grade I envenomation. No evidence that patients were randomised or that treatment was blinded. Statistical analysis of clinical features unclear. There appears to be a 50% baseline difference in incidence of systemic symptoms between the antivenom and no antivenom groups in favour of the antivenom group
Local symptomsGreater reduction in local pain and burning reported with antivenom
Systemic symptomsLower incidence of systemic symptoms in the antivenom group