Evaluation of The effects of Anti-Inflammatory Drugs on Local and Systemic manifestations of snakebite: A cross-sectional study.

Abstract

Although the predominant treatment for snakebite is the antivenom, other treatments are also considered. We studied the effects of single or multiple-doses of anti-inflammatory drugs on local, systemic and laboratory findings of the snakebite victims. In this cross-sectional study, 101 patients (90 male: 89.1%) with snakebite envenomation who were admitted to the Medical Toxicology Center of Khorshid Hospital, Isfahan, Iran, were investigated. One group (35 patients: 34.7%) received a single-dose of anti-inflammatory drugs containing chlorpheniramine (10mg intramuscular injection) with cimetidine (200mg intravenous injection) or ranitidine (50mg intravenous injection) plus hydrocortisone (100mg intravenous injection). The other 55 patients (54.5%) received multiple doses of the same drug combination every 8hr until the symptoms resolved. Local, systemic symptoms and laboratory findings on admission, and during 24hr and 48hr of admission, were recorded. The frequency of the localized signs of inflammation (p=0.03), swelling (p<0.001) and bruising (p<0.001) showed a significant difference between the two treated groups. In addition, the recovery time in the patients who received multiple doses was faster (p<0.001). There was no significant difference in any of the systemic signs, laboratory findings or the outcome between the patients in the various groups during hospitalization. Our data indicate that the administration of multiple doses of anti-inflammatory drugs had a greater effect on reducing local symptoms of snakebite including inflammatory manifestations.