Venomous Snakebites Worldwide with a Focus on the Australia-Pacific Region: Current Management and Controversies

Abstract

Snakebites are estimated to cause approximately 100,000 deaths each year worldwide and disproportionately affect rural populations in resource-poor settings. Snake venoms may produce local tissue damage and/or distinct clinical syndromes, including neurotoxicity, coagulopathy, hypotension, rhabdomyolysis, and renal failure. Field management is aimed at delaying systemic absorption of toxins, minimizing local damage and infection, and expediting transport to medical facilities. The use of the pressure-immobilization method remains controversial. The use of antivenom, administered in a timely fashion and in adequate doses, is the mainstay of hospital treatment of significant envenomation. The availability, efficacy, and safety of antivenoms vary throughout the world, with a current crisis in antivenom supplies.

Snakebite envenoming in Kerala, South India: clinical profile and factors involved in adverse outcomes

“…Those who received SAV late had a greater likelihood of developing complications than those who received SAV early. Timely administration of antivenom is the mainstay of treatment for snakebite envenoming, and there is a definite correlation between the development of complications and bite to needle time 3 5 7 10 – 12 20 23 24. High mortality is also related to the delay in treatment 12 15 16 19 23.…”

“…Snakebites are estimated to cause 100 000 deaths each year worldwide and disproportionately affect rural populations in resource-poor settings 3. Complications set in fast, and the physician may lose valuable time and the patient unless she/he is very careful.…”

“…Administration of antivenom is the mainstay of treatment 3 4 6 7 9 – 11. Proper and timely administration of antivenom and supportive therapy may affect the rate of complications and the outcome in most situations 3 – 16…”

Poor efficacy of preemptive amoxicillin clavulanate for preventing secondary infection from Bothrops snakebites in the Brazilian Amazon: A randomized controlled clinical trial

“…Several antimicrobial schemes were suggested for the treatment of secondary infections, but in general these recommendations were not based on good evidences from clinical trials [36,37]. For example, ampicillin/cephalosporin/cloxacillin [14,27], ciprofloxacin [15,22] and clindamycin [36,38,39] were previously used for secondary bacterial infections resulted from snakebites, with variable effectiveness.…”

Histopathological analysis and in situ localisation of Australian tiger snake venom in two clinically envenomed domestic animals

“…Although Tiger snake envenoming has been widely reported to cause kidney damage in clinically envenomed patients (Cheng and Currie 2004;Currie 2000;Hood 1975;Jolles et al 1998;White 1995), it is unclear whether renal failure is a direct result of the venom's nephrotoxicity or a secondary effect of myoglobinuria. Different types of kidney damage induced by snake venoms and purified venom toxins (from snakes found outside Australia) has been thoroughly reviewed by Sitprija et al, (1982) (Sitprija et al 1982, allowing us to utilise this work when examining kidney damage caused by Australian snakes.…”