Antivenom Does Not Cause Snakebite Complications, Withholding It Does

Charles J Gerardo, Andrew W. Godfrey, Spencer Greene

Research output: Contribution to journalLetterpeer-review


We read with interest the retrospective chart review “Crotalidae Polyvalent Immune Fab and Cost-Effective Management of Hospital Admission for Snakebites” by Bowden, et al. The efficacy of US snake antivenoms has been well established for decades. A randomized double-blind placebo-controlled clinical trial (RCT) has demonstrated Fab antivenom efficacy using patient-centered outcomes such as return of functionality and other patient-reported outcomes. These benefits occurred in a predominantly mildly envenomated patient population in a time-dependent manner. The cost-effectiveness of snake antivenom has been demonstrated globally, but no US cost-effectiveness studies have been published. Based on the evidence hierarchy of evidence-based medicine, the discordance between this study and the RCT merits discussion.

Original languageEnglish
Pages (from-to)1381-1382
Number of pages2
JournalAmerican Surgeon
Issue number6
StatePublished - Jun 2022
Externally publishedYes


  • antivenin
  • cost-effectiveness
  • outcomes
  • snake bite


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