Review on the evolution of antivenoms for snakebites treatment

In Colombia, around 5000 cases of snakebites reported annually, the only specific therapy for the treatment of snakebite are antivenoms, complete immunoglobulins purified or (Fab)2 antivenoms. Objective: To present differences between the generations of antivenoms, the importance of the venom´s snake in the antivenom production, compare pharmacokinetic aspects and side effects in patients.

Materials and Methods: A review literature was conducted in databases using combinations of Mesh descriptors and terms, in English and Spanish. Pharmacokinetic parameters were compared in preclinical studies and side effects in clinical studies. Results: Differences were found due to the size of the fraction of the immunoglobulin, so the smaller this is, the greater distribution to the tissues and a shorter half-life is observed, compared with the heavier molecules. At the clinical level, studies were found with a slight decrease in side effects when using F(ab)2 antivenoms compared with the use of antivenom sera, but without statistically significant differences.

Conclusion: the process of elaboration of the antivenoms is determinant to evaluate and compare objectively the parameters measured in vitro and in vivo for this medicine.