Immediate hypersensitivity reaction associated with the rapid infusion of Crotalidae polyvalent immune Fab (ovine)

Holstege, Christopher P.; Wu, Jeffrey; Baer, Alexander B.

doi:10.1067/mem.2002.124442

Cited by 33 publications

(22 citation statements)

References 7 publications

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“…All patients responded to basic measures. Despite these data, care must still be taken when administering CroFab because cases of life-threatening immediate hypersensitivity reactions have been reported [25,26].…”

Section: Safetymentioning

confidence: 97%

Antivenom therapy for snakebites in children: is there evidence?

Schmidt¹

2005

Current Opinion in Pediatrics

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Section: Safetymentioning

confidence: 97%

Antivenom therapy for snakebites in children: is there evidence?

Schmidt¹

2005

Current Opinion in Pediatrics

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“…FabAV has been associated with diminished adverse events from 0% to 14% compared with ACP, although there is a trend towards a lower incidence in children 7 15 17. Based on our review, the incidence of adverse events is 8.5%, including both acute and late adverse reactions 8 – 17. The majority of adverse events were infusion related.…”

Section: Discussionmentioning

confidence: 79%

“…Six case reports, three descriptive reports and one randomised controlled trial met the inclusion criteria, representing 47 children 8 – 17 Table 1. lists the baseline characteristics of these patients.…”

Section: Resultsmentioning

confidence: 99%

“…However, due to the retrospective nature of their report, the authors could not identify the specific adverse events in the patient. In addition, Holstege and colleagues8 reported an additional case of an acute reaction in a 16-year-old man following a rapid bolus of FabAV. The FabAV was prepared by mixing 6 g in 250 ml of 0.9% sodium chloride USP and the infusion was initiated at 10 ml/h.…”

Section: Resultsmentioning

confidence: 99%

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Utilisation of Crotalidae polyvalent immune fab (ovine) for Viperidae envenomations in children

Johnson

McGoodwin

Banner

2008

Emergency Medicine Journal

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Snakebite envenomations occur in 45,000 patients in the USA annually and are associated with morbidity especially in children and the elderly. Crotalidae polyvalent immune fab (ovine; FabAV) is a polyvalent antivenom derived from sheep for crotalid envenomations. Limited clinical trials are available in paediatric patients. A literature search using MEDLINE (1950-February 2008), International Pharmaceutical Abstracts (1970-February 2008), EMBASE (1988-February 2008) and Cochrane Library (1996-June 2008) was conducted using key words including: antivenom OR snakebites OR children OR Crotalid OR envenomations. All English-language articles were identified from data sources. Pertinent studies pertaining to FabAV in children and adolescents with crotalid envenomations were included for analysis. Ten papers were included for review, representing 47 children. Initial doses ranging from 2 to 18 g were administered and initial control was achieved in most children. Maintenance dosing was continued in 63.8% (30/47) of patients; 4.3% (2/47) of patients had episodes of venom recurrence. Adverse events were noted in 8.5% of children (4/47) when pooled for data analysis. FabAV appears to be a safe and effective agent for children with crotalid envenomations. Clinicians should adapt dosing recommendations used for adults until future large, well-designed trials can confirm the efficacy and safety from observation studies and case reports.

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“…Angioedema and severe allergic responses rarely occur, with only 2 cases of anaphylaxis described in the literature (11,13,15). Another case was thought to be due to rapid administration (17). One study, by Dart et al, found that serum sickness occurred in 23% of studied patients (18).…”

Section: Discussionmentioning

confidence: 91%