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Title: Effectiveness of snake antivenom: Species and regional venom variation and its clinical impact
Authors: Fry, B.G. 
Winkel, K.D.
Wickramaratna, J.C.
Hodgson, W.C.
Wüster, W.
Issue Date: 2003
Citation: Fry, B.G., Winkel, K.D., Wickramaratna, J.C., Hodgson, W.C., Wüster, W. (2003). Effectiveness of snake antivenom: Species and regional venom variation and its clinical impact. Journal of Toxicology - Toxin Reviews 22 (1) : 23-34. ScholarBank@NUS Repository.
Abstract: The ubiquity of venom variation in snakes poses special problems for the manufacture of antivenom and has undermined the commercial attractiveness of this class of therapeutic agent. In particular, it has been amply documented that both interspecific and intraspecific variation in venom composition can affect the neutralisation capacity of antivenoms. This may be exacerbated by the selective use of tests of venom toxicity and antivenom efficacy, such as the lethal dose and ED50, resulting in inadequate neutralisation of time, rather than dose, dependent toxins, particularly enzymes involved in defibrinogenating, haemorrhagic and necrotising venom activities. The clinical consequences can be reduced efficacy against some important venom activities or even complete treatment failure in critical envenomations. All these factors, combined with the ongoing reduction in the number of antivenom manufacturers world-wide, and concomitant contraction in the range of available antivenoms, present significant challenges for the treatment of snakebite in the 21st century.
Source Title: Journal of Toxicology - Toxin Reviews
ISSN: 07313837
DOI: 10.1081/TXR-120019018
Appears in Collections:Staff Publications

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