A double-blind,randomized trial of intravenous versus intramuscular antivenom for Red-back spider envenoming

R.M. Ellis, Peter Sprivulis, George Jelinek, N.D.G. Banham, S.V. Wood, G.J. Wilkes, A. Siegmund, B.L. Roberts

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objective:  To compare the efficacy of intravenous versus intramuscular antivenom (AV) in the treatment of Red-back spider (RBS) envenoming.Methods:  Randomized, double-dummy, double-blind, multicentre trial of patients with red-back spider envenoming requiring AV treatment recruited from five hospital EDs in Western Australia.Results:  Thirty-five patients were recruited; two were excluded; 33 were available for initial analysis, but two who were unblinded after one ampoule of trial AV and given i.v. AV had limited data; 31 remained in the study and had more complete data. After AV, pain scores for both i.m. and i.v. groups improved rapidly. At 24 h, the i.v. group was better with a 55% absolute difference (76% vs. 21%; 95% CI 25–85% difference) in the proportion pain-free. There were no safety issues.Conclusions:  Red-back spider antivenom was initially effective by both i.m. and i.v. routes. The study generates the hypothesis that at 24 h, significantly more patients are pain-free with i.v. administration. Definitive recommendations on the optimal route of administration of RBS AV await the results of further studies.
Original languageEnglish
Pages (from-to)152-156
JournalEmergency Medicine Australasia
Volume17
Issue number2
Publication statusPublished - 2005

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Antivenins
Spiders
Western Australia
Multicenter Studies
Safety
Pain
Therapeutics

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Ellis, R. M., Sprivulis, P., Jelinek, G., Banham, N. D. G., Wood, S. V., Wilkes, G. J., ... Roberts, B. L. (2005). A double-blind,randomized trial of intravenous versus intramuscular antivenom for Red-back spider envenoming. Emergency Medicine Australasia, 17(2), 152-156.
Ellis, R.M. ; Sprivulis, Peter ; Jelinek, George ; Banham, N.D.G. ; Wood, S.V. ; Wilkes, G.J. ; Siegmund, A. ; Roberts, B.L. / A double-blind,randomized trial of intravenous versus intramuscular antivenom for Red-back spider envenoming. In: Emergency Medicine Australasia. 2005 ; Vol. 17, No. 2. pp. 152-156.
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abstract = "Objective:  To compare the efficacy of intravenous versus intramuscular antivenom (AV) in the treatment of Red-back spider (RBS) envenoming.Methods:  Randomized, double-dummy, double-blind, multicentre trial of patients with red-back spider envenoming requiring AV treatment recruited from five hospital EDs in Western Australia.Results:  Thirty-five patients were recruited; two were excluded; 33 were available for initial analysis, but two who were unblinded after one ampoule of trial AV and given i.v. AV had limited data; 31 remained in the study and had more complete data. After AV, pain scores for both i.m. and i.v. groups improved rapidly. At 24 h, the i.v. group was better with a 55{\%} absolute difference (76{\%} vs. 21{\%}; 95{\%} CI 25–85{\%} difference) in the proportion pain-free. There were no safety issues.Conclusions:  Red-back spider antivenom was initially effective by both i.m. and i.v. routes. The study generates the hypothesis that at 24 h, significantly more patients are pain-free with i.v. administration. Definitive recommendations on the optimal route of administration of RBS AV await the results of further studies.",
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Ellis, RM, Sprivulis, P, Jelinek, G, Banham, NDG, Wood, SV, Wilkes, GJ, Siegmund, A & Roberts, BL 2005, 'A double-blind,randomized trial of intravenous versus intramuscular antivenom for Red-back spider envenoming' Emergency Medicine Australasia, vol. 17, no. 2, pp. 152-156.

A double-blind,randomized trial of intravenous versus intramuscular antivenom for Red-back spider envenoming. / Ellis, R.M.; Sprivulis, Peter; Jelinek, George; Banham, N.D.G.; Wood, S.V.; Wilkes, G.J.; Siegmund, A.; Roberts, B.L.

In: Emergency Medicine Australasia, Vol. 17, No. 2, 2005, p. 152-156.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A double-blind,randomized trial of intravenous versus intramuscular antivenom for Red-back spider envenoming

AU - Ellis, R.M.

AU - Sprivulis, Peter

AU - Jelinek, George

AU - Banham, N.D.G.

AU - Wood, S.V.

AU - Wilkes, G.J.

AU - Siegmund, A.

AU - Roberts, B.L.

PY - 2005

Y1 - 2005

N2 - Objective:  To compare the efficacy of intravenous versus intramuscular antivenom (AV) in the treatment of Red-back spider (RBS) envenoming.Methods:  Randomized, double-dummy, double-blind, multicentre trial of patients with red-back spider envenoming requiring AV treatment recruited from five hospital EDs in Western Australia.Results:  Thirty-five patients were recruited; two were excluded; 33 were available for initial analysis, but two who were unblinded after one ampoule of trial AV and given i.v. AV had limited data; 31 remained in the study and had more complete data. After AV, pain scores for both i.m. and i.v. groups improved rapidly. At 24 h, the i.v. group was better with a 55% absolute difference (76% vs. 21%; 95% CI 25–85% difference) in the proportion pain-free. There were no safety issues.Conclusions:  Red-back spider antivenom was initially effective by both i.m. and i.v. routes. The study generates the hypothesis that at 24 h, significantly more patients are pain-free with i.v. administration. Definitive recommendations on the optimal route of administration of RBS AV await the results of further studies.

AB - Objective:  To compare the efficacy of intravenous versus intramuscular antivenom (AV) in the treatment of Red-back spider (RBS) envenoming.Methods:  Randomized, double-dummy, double-blind, multicentre trial of patients with red-back spider envenoming requiring AV treatment recruited from five hospital EDs in Western Australia.Results:  Thirty-five patients were recruited; two were excluded; 33 were available for initial analysis, but two who were unblinded after one ampoule of trial AV and given i.v. AV had limited data; 31 remained in the study and had more complete data. After AV, pain scores for both i.m. and i.v. groups improved rapidly. At 24 h, the i.v. group was better with a 55% absolute difference (76% vs. 21%; 95% CI 25–85% difference) in the proportion pain-free. There were no safety issues.Conclusions:  Red-back spider antivenom was initially effective by both i.m. and i.v. routes. The study generates the hypothesis that at 24 h, significantly more patients are pain-free with i.v. administration. Definitive recommendations on the optimal route of administration of RBS AV await the results of further studies.

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JO - Emergency Medicine

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SN - 1742-6723

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Ellis RM, Sprivulis P, Jelinek G, Banham NDG, Wood SV, Wilkes GJ et al. A double-blind,randomized trial of intravenous versus intramuscular antivenom for Red-back spider envenoming. Emergency Medicine Australasia. 2005;17(2):152-156.