Crotaline Fab Antivenom for the Treatment of Children With Rattlesnake Envenomation

Offerman, Steven R.; Bush, Sean P.; Moynihan, James A.; Clark, Richard F.

doi:10.1542/peds.110.5.968

Cited by 69 publications

(60 citation statements)

References 29 publications

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“…Other postmarketing studies have been performed since the approval of CroFab but included limited numbers of children. The most extensive pediatric studies to date were performed by Ruha et al 3 and Offerman et al 5 but only described a combined total of 15 pediatric patients younger than 13 years of age. The only other pediatric data available on CroFab use has been from a few case reports (one patient for each of three case reports), which are unique by nature and do not necessarily represent typical pediatric envenomations.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Crotalidae Polyvalent Immune Fab in Pediatric Crotaline Envenomations

Pizon¹,

Riley²,

LoVecchio³

et al. 2007

Acad Emergency Med

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Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Crotalidae Polyvalent Immune Fab in Pediatric Crotaline Envenomations

Pizon¹,

Riley²,

LoVecchio³

et al. 2007

Acad Emergency Med

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“…Since the release of CroFab™ in December 2000 for the management of snake bites, there has been significant investigation regarding its efficacy and safety (9,(11)(12)(13)(14)(15)(16). Initial rodent studies found that Fab antivenin was five times as potent as its predecessor, ACP (11,12).…”

Section: Discussionmentioning

confidence: 99%

“…Initial rodent studies found that Fab antivenin was five times as potent as its predecessor, ACP (11,12). Dart and McNally in 2001 found that crotalid Fab antivenin was safer than ACP and less likely to cause the serum sickness that is common with ACP antivenin (11).…”

Section: Discussionmentioning

confidence: 99%

“…Review of current literature did not reveal any data on crotalid Fab antivenin use for pediatric copperhead envenomations. There has been only one study documenting its use in the very young pediatric population (12). This 12-patient study reported the successful use of crotalid Fab antivenin in pediatric patients bitten by rattlesnakes and included 4 patients who were aged 5 years or under, with the youngest patient in the study being 14 months of age (12).…”

Section: Discussionmentioning

confidence: 99%

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Use of CroFab® antivenin in the management of a very young pediatric copperhead envenomation

Trinh¹,

Hack²

2005

The Journal of Emergency Medicine

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“…4,5 When indicated, treatment with antivenom requires close patient monitoring to respond to potential anaphylaxis. 1 Many forms of antiven om, including that for snake bites, are very expensive.…”

Section: Resource Utilization Of Pediatric Patients Exposed To Venommentioning

confidence: 99%

Resource Utilization of Pediatric Patients Exposed to Venom

Narra

Lie

Hall

et al. 2014

Hospital Pediatrics

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BACKGROUND AND OBJECTIVE:Treating envenomation with antivenom is costly. Many patients being treated with antivenom are in observation status, a billing designation for patients considered to need care that is less resourceintensive, and less expensive, than inpatient care. Observation status is also associated with lower hospital reimbursements and higher patient cost-sharing. The goal of this study was to examine resource utilization for treatment of envenomation under observation and inpatient status, and to compare patients in observation status receiving antivenom with all other patients in observation status. METHODS:This was a retrospective study of patients with a primary diagnosis of toxic effect of venom seen during 2009 at 33 freestanding children's hospitals in the Pediatric Health Information System. Data on age, length of stay, adjusted costs (ratio cost to charges), ICU fl ags, and antivenom utilization were collected. Comparisons were conducted according to admission status (emergency department only, observation status, and inpatient status), and between patients in observation status receiving antivenom and patients in observation status with other diagnoses. RESULTS:A total of 2755 patients had a primary diagnosis of toxic effect of venom. Of the 335 hospitalized, either under observation (n = 124) or inpatient (n = 211) status, 107 (31.9%) received antivenom. Of those hospitalized patients receiving antivenom, 24 (22.4%) were designated as observation status. Costs were substantially higher for patients who received antivenom and were driven by pharmacy costs (mean cost: $17 665 for observation status, $20 503 for inpatient status). Mean costs for the 47 162 patients in observation status with other diagnoses were $3001 compared with $17 665 for observation-status patients who received antivenom. 6-8 However, few studies have addressed the treatment burden associated with envenomation cases or the impact of the designated medical service type on resource utilization and costs. CONCLUSIONS:The Centers for Medicare & Medicaid Services (CMS) coined the term "observation status" to describe patients not meeting inpatient Diagnosis Related Group criteria and deemed by payers to be in a state of clinical decisionmaking between discharge-to-home and admission-to-inpatient status. 9They defined the care a patient receives while in observation status as a set of services delivered "before a decision can be made regarding whether patients will require further treatment as hospital inpatients or if they are able to be discharged from the hospital."10 Because patients in observation status have not officially been admitted to the hospital, the care they receive in emergency departments (EDs) or in the hospital is considered outpatient care and is commonly reimbursed at lower rates than care provided to patients with an inpatient status, as observation-status care is presumed to be less resourceintensive.11 Antivenom treatments followed by ongoing care (including being observed for complications)...

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Crotaline Fab Antivenom for the Treatment of Children With Rattlesnake Envenomation

Abstract: In this group of pediatric patients treated for rattlesnake envenomation, crotaline Fab antivenom was safe and seemed to be effective.

Cited by 69 publications

References 29 publications

Safety and Efficacy of Crotalidae Polyvalent Immune Fab in Pediatric Crotaline Envenomations

Safety and Efficacy of Crotalidae Polyvalent Immune Fab in Pediatric Crotaline Envenomations

Use of CroFab® antivenin in the management of a very young pediatric copperhead envenomation

Resource Utilization of Pediatric Patients Exposed to Venom

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