Comparative study of the efficacy and safety of two polyvalent, caprylic acid fractionated [IgG and F(ab′)2] antivenoms, in Bothrops asper bites in Colombia

Anticomplementary Activity of Horse IgG and F(ab')2 Antivenoms

“…7,8 However, various studies have shown that both types of antivenoms can activate the complement system in vitro 9,10 and induce EARs in patients. 11,12 Some data highlight the impact of the fractionation protocol on the induction of EARs. It was shown that IgG antivenom precipitated by ammonium sulphate had more aggregates and induced a higher incidence of EARs than IgG antivenom precipitated by caprylic acid.…”

Snakebites in Colombia

“…It has been demonstrated that antivenoms made of whole IgG obtained by ammonium sulfate precipitation have higher in vitro anticomplementary activity and, accordingly, induce a relatively high incidence of . In contrast, a lower incidence of EARs has been described after the administration of caprylic acidfractionated whole IgG and F(ab') 2 preparations (11-29 %) (Otero-Patiño 2009;Otero-Patiño et al 2012).…”

“…In Colombia, two whole IgG polyvalent antivenoms, manufactured by Instituto Nacional de Salud (INS; neutralizing potency 70 mg B. asper venom per 10 ml vial) and Probiol (neutralizing potency 25 mg B. asper venom/vial), and one F(ab 0 ) 2 antivenom imported from Mexico (Bioclon; neutralizing potency 30 mg B. asper venom/vial) are produced and/or distributed (Table 2). In addition, antivenoms from Brazil, Costa Rica, and Venezuela, with differences in potency, have neutralizing capacity against B. asper venom from Colombia, as demonstrated experimentally (Otero et al , 1997(Otero et al , 2002b) and clinically (Otero-Patiño et al 2012).…”

“…Diagnosis can be established by means of appropriate imaging (Rx, computed tomography, magnetic resonance, angiography, ultrasound, etc.). (f) Other complications of B. asper bites are hematic or serous pleural effusions in severe cases affecting the chest and upper extremities (Otero-Patiño 2009;Otero-Patiño et al 2012) (Fig. 22).…”

“…Once EAR symptoms have subsided or ameliorated (usually within 15 min), antivenom infusion should be continued with caution. If EARs repeat, a parallel continuous infusion of adrenaline (1.0 mg diluted in 250 ml 0.9 % NaCl solution) should be administered during the antivenom infusion (Otero 2007;Otero-Patiño 2009;Otero-Patiño et al 2012).…”