10 Vials versus 20 Vials Antivenom Therapy in Krait Bite Neuroparalysis: An Open-Label Randomized Controlled Trial (Code-T0192)

Introduction: Snake envenomation, a significant public health concern in tropical regions, necessitates effective antivenom therapy. In India, Bungarus caeruleus (common krait) bites are a leading cause of neuroparalysis. The optimal dosage of antivenom remains debated, with potential implications for resource allocation and patient outcomes.

Aims and Objectives:

Aims: 

To evaluate the efficacy of a single dose of 10 vialsof ASV in treating neuroparalysis caused by Krait envenomation.

Objectives: 

To compare the outcomes of the patients receiving10 vials versus 20 vials(administered as two doses of 10 vials) of ASVin cases of Krait bite where mechanical ventilation is not required at the time of enrolment.

Methods: This open-label, randomized controlled trial, conducted at PGIMER Chandigarh, includes 50 patients diagnosed with krait bite neuroparalysis. Participants are randomized into two groups: one receiving 10 vials and the other 20 vials of antivenom. Clinical outcomes, laboratory parameters, and patient recovery are tracked. Statistical analysis involves Kaplan-Meier survival curves and Chi-square/Fisher’s exact tests.

Results: Expected results focus on demonstrating comparable efficacy of 10 vials versus 20 vials in reversing neuroparalysis, potentially reducing antivenom usage without compromising outcomes. Preliminary findings suggest no significant difference in key clinical endpoints.

Conclusion: A low-dose antivenom regimen (10 vials) appears as effective as a higher dose (20 vials) for treating krait bite neuroparalysis, offering cost-effective and resource-efficient management strategies in endemic regions.

Keywords: Krait bite, antivenom therapy, neuroparalysis, randomized trial, low-dose regimen, resource optimization.