Abstract

Background: Daboia (Vipera) palaestinae envenomation (DPE) is the most common snake-bite in Israel. Current practice has supported antivenom treatment, including those with local or systemic manifestations.Objective: To evaluate a conservative approach vs. fixed dose D. palaestinae antivenom for patients with advance local (AL)/mild systemic (MS) manifestations.Methods: Retrospective analysis of 41 patients bitten by D. palaestinae who were treated with expectant management or administration of a fixed-dose of 50 mL antivenom.Results: Antivenom was withheld in 16/21 patients (76%) with AL or MS reaction. After expectant management, no adverse events were recorded.Conclusion: We found that a selective approach towards antivenom administration yields similar clinical outcomes in patients following DPE.

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