Low-dose versus standard-dose antivenom for neuroparalytic krait envenomation: a randomized pilot study.
Clin Toxicol (Phila)Apr 20, 2026 (epub)
Siva Jyothika, Prannoy George Mathen, Ripudaman Sharma et al.
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In 30 seconds
This randomized pilot study evaluated the efficacy of low-dose (10 vials) versus standard-dose (20 vials) polyvalent antivenom in patients with neuroparalytic krait envenomation in North India. The study found no significant difference in the median time to recovery from neurotoxic paralysis, which was 42.5 hours for the 10-vial group and 45.0 hours for the 20-vial group (P = 0.24).
Key findings
- Median time to recovery was 42.5 hours for the 10-vial group and 45.0 hours for the 20-vial group (P = 0.24).
- Invasive mechanical ventilation was required in 34.6% of the 10-vial group and 22.2% of the 20-vial group (risk ratio, 1.34).
- One death occurred in the 10-vial group during the study.
Why it matters
This study challenges the necessity of escalating antivenom doses in cases of neuroparalytic krait envenomation, suggesting that lower doses may be sufficient when combined with careful respiratory monitoring and supportive care.