A randomized comparative study between intravenous and intramuscular scorpion antivenom regimens in children

• Published in: Toxicon (Oxford) 2019-03, Vol.159, p.45-49
• Main Authors: El-Asheer, Osama M., Hammad, Emad E.M., Mohamad, Ismail L., Saad, Khaled, Aziz, Nancy A.
• Format: Article
• Language: English
• Subjects: Children; Intramuscular; Intravenous; Scorpion antivenom
• ISSN: 0041-0101; 1879-3150
• DOI: 10.1016/j.toxicon.2019.01.004

Scorpion envenomation and its consequences represented a serious healthcare problem in Upper Egypt and considered to be an important cause of life-threatening emergency particularly in children. One hundred patients presented to the emergency department of Assiut University Children Hospital with a history of scorpion sting aged less than 18 years were included in our randomized comparative trial during 2016. Two groups of patients were randomly categorized according to the route of administration of scorpion antivenom; intramuscular and intravenous with 50 patients in each group. Full history, clinical examination, and routine baseline investigations were performed. Myocarditis, encephalopathy, cardiogenic shock, ICU admission, need for mechanical ventilation, mean hospital stay and mortality were significantly lower in those received intravenous antivenom compared with those received intramuscular one. The results of the present study and other experimental and clinical trials confirmed that the administration of the scorpion antivenom by intravenous route has a lower incidence of systemic toxicity, a better outcome of fatal complication resulted from envenomation especially cardiogenic shock, decreased need for ICU facilities and mechanical ventilation, shorter hospital stay, and better overall outcome than the intramuscular route. UMIN-CTR Study Design: trial number: UMIN000022032. •Administration of the scorpion antivenom by IV route has a lower incidence of systemic toxicity than IM route•It also leads to a decreased incidence of severe complications of scorpionism.•Our study is a crucial step to improve the guidelines for optimal immunotherapy for scorpion envenomations in children.