Staff View: Experience of using expired lyophilized snake antivenom during a medical emergency situation in Lao People's Democratic Republic: A possible untapped resource to tackle antivenom shortage in Southeast Asia

Experience of using expired lyophilized snake antivenom during a medical emergency situation in Lao People's Democratic Republic: A possible untapped resource to tackle antivenom shortage in Southeast Asia

Objectives: To evaluate the safety and efficacy of expired lyophilized snake antivenom of Thai origin during a medical emergency in 2020/2021 in Lao People's Democratic Republic. Methods: Observational case series of patients with potentially life-threatening envenoming who consented to the adm...

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Main Authors:	Blessmann, Joerg, Hanlodsomphou, Soulaphab, Santisouk, Bounlom, Krumkamp, Ralf, Kreuels, Benno, Ismail, Ahmad Khaldun, Yong, Mun Yee, Tan, Kae Yi, Tan, Choo Hock
Format:	Article
Published:	Wiley 2023
Subjects:	RM Therapeutics. Pharmacology RS Pharmacy and materia medica
Online Access:	http://eprints.um.edu.my/39231/
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spelling	my.um.eprints.392312023-11-29T03:47:03Z http://eprints.um.edu.my/39231/ Experience of using expired lyophilized snake antivenom during a medical emergency situation in Lao People's Democratic Republic: A possible untapped resource to tackle antivenom shortage in Southeast Asia Blessmann, Joerg Hanlodsomphou, Soulaphab Santisouk, Bounlom Krumkamp, Ralf Kreuels, Benno Ismail, Ahmad Khaldun Yong, Mun Yee Tan, Kae Yi Tan, Choo Hock RM Therapeutics. Pharmacology RS Pharmacy and materia medica Objectives: To evaluate the safety and efficacy of expired lyophilized snake antivenom of Thai origin during a medical emergency in 2020/2021 in Lao People's Democratic Republic. Methods: Observational case series of patients with potentially life-threatening envenoming who consented to the administration of expired antivenom between August 2020 and May 2022. Results: A total of 31 patients received the expired antivenom. Malayan pit vipers (Calloselasma rhodostoma) were responsible for 26 (84%) cases and green pit vipers (Trimeresurus species) for two cases (6%). In three patients (10%) the responsible snake could not be identified. Of these, two presented with signs of neurotoxicity and one with coagulopathy. A total of 124 vials of expired antivenom were administered. Fifty-nine vials had expired 2-18 months earlier, 56 vials 19-36 months and nine vials 37-60 months before. Adverse effects of variable severity were observed in seven (23%) patients. All 31 patients fully recovered from systemic envenoming. Conclusions: Under closely controlled conditions and monitoring the use of expired snake antivenom proved to be effective and safe. Discarding this precious medication is an unnecessary waste, and it could be a valuable resource in ameliorating the current shortage of antivenom. Emergency use authorization granted by health authorities and preclinical testing of expired antivenoms could provide the support and legal basis for such an approach. Wiley 2023-01 Article PeerReviewed Blessmann, Joerg and Hanlodsomphou, Soulaphab and Santisouk, Bounlom and Krumkamp, Ralf and Kreuels, Benno and Ismail, Ahmad Khaldun and Yong, Mun Yee and Tan, Kae Yi and Tan, Choo Hock (2023) Experience of using expired lyophilized snake antivenom during a medical emergency situation in Lao People's Democratic Republic: A possible untapped resource to tackle antivenom shortage in Southeast Asia. Tropical Medicine and International Health, 28 (1). pp. 64-70. ISSN 1360-2276, DOI https://doi.org/10.1111/tmi.13833 <https://doi.org/10.1111/tmi.13833>. 10.1111/tmi.13833
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	RM Therapeutics. Pharmacology RS Pharmacy and materia medica
spellingShingle	RM Therapeutics. Pharmacology RS Pharmacy and materia medica Blessmann, Joerg Hanlodsomphou, Soulaphab Santisouk, Bounlom Krumkamp, Ralf Kreuels, Benno Ismail, Ahmad Khaldun Yong, Mun Yee Tan, Kae Yi Tan, Choo Hock Experience of using expired lyophilized snake antivenom during a medical emergency situation in Lao People's Democratic Republic: A possible untapped resource to tackle antivenom shortage in Southeast Asia
description	Objectives: To evaluate the safety and efficacy of expired lyophilized snake antivenom of Thai origin during a medical emergency in 2020/2021 in Lao People's Democratic Republic. Methods: Observational case series of patients with potentially life-threatening envenoming who consented to the administration of expired antivenom between August 2020 and May 2022. Results: A total of 31 patients received the expired antivenom. Malayan pit vipers (Calloselasma rhodostoma) were responsible for 26 (84%) cases and green pit vipers (Trimeresurus species) for two cases (6%). In three patients (10%) the responsible snake could not be identified. Of these, two presented with signs of neurotoxicity and one with coagulopathy. A total of 124 vials of expired antivenom were administered. Fifty-nine vials had expired 2-18 months earlier, 56 vials 19-36 months and nine vials 37-60 months before. Adverse effects of variable severity were observed in seven (23%) patients. All 31 patients fully recovered from systemic envenoming. Conclusions: Under closely controlled conditions and monitoring the use of expired snake antivenom proved to be effective and safe. Discarding this precious medication is an unnecessary waste, and it could be a valuable resource in ameliorating the current shortage of antivenom. Emergency use authorization granted by health authorities and preclinical testing of expired antivenoms could provide the support and legal basis for such an approach.
format	Article
author	Blessmann, Joerg Hanlodsomphou, Soulaphab Santisouk, Bounlom Krumkamp, Ralf Kreuels, Benno Ismail, Ahmad Khaldun Yong, Mun Yee Tan, Kae Yi Tan, Choo Hock
author_facet	Blessmann, Joerg Hanlodsomphou, Soulaphab Santisouk, Bounlom Krumkamp, Ralf Kreuels, Benno Ismail, Ahmad Khaldun Yong, Mun Yee Tan, Kae Yi Tan, Choo Hock
author_sort	Blessmann, Joerg
title	Experience of using expired lyophilized snake antivenom during a medical emergency situation in Lao People's Democratic Republic: A possible untapped resource to tackle antivenom shortage in Southeast Asia
title_short	Experience of using expired lyophilized snake antivenom during a medical emergency situation in Lao People's Democratic Republic: A possible untapped resource to tackle antivenom shortage in Southeast Asia
title_full	Experience of using expired lyophilized snake antivenom during a medical emergency situation in Lao People's Democratic Republic: A possible untapped resource to tackle antivenom shortage in Southeast Asia
title_fullStr	Experience of using expired lyophilized snake antivenom during a medical emergency situation in Lao People's Democratic Republic: A possible untapped resource to tackle antivenom shortage in Southeast Asia
title_full_unstemmed	Experience of using expired lyophilized snake antivenom during a medical emergency situation in Lao People's Democratic Republic: A possible untapped resource to tackle antivenom shortage in Southeast Asia
title_sort	experience of using expired lyophilized snake antivenom during a medical emergency situation in lao people's democratic republic: a possible untapped resource to tackle antivenom shortage in southeast asia
publisher	Wiley
publishDate	2023
url	http://eprints.um.edu.my/39231/
_version_	1783876678650429440
score	13.211869

Experience of using expired lyophilized snake antivenom during a medical emergency situation in Lao People's Democratic Republic: A possible untapped resource to tackle antivenom shortage in Southeast Asia

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