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Commercial monovalent antivenoms in Australia are polyvalent

O'Leary, MA and Isbister, GK (2009). Commercial monovalent antivenoms in Australia are polyvalent. Toxicon,54(2):192-195.

Document type: Journal Article
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Title Commercial monovalent antivenoms in Australia are polyvalent
Author O'Leary, MA
Isbister, GK
Journal Name Toxicon
Publication Date 2009
Volume Number 54
Issue Number 2
ISSN 0041-0101   (check CDU catalogue open catalogue search in new window)
Start Page 192
End Page 195
Total Pages 4
Place of Publication UK
Publisher Pergamon
HERDC Category C1 - Journal Article (DEST)
Abstract Monovalent antivenoms have a lower volume of specific antibodies that may reduce reactions but require accurate snake identification to be used. Polyvalent antivenoms are larger volume and may have a higher reaction rate. However, they avoid the problem of snake identification and may be more cost-effective to manufacture. We have previously shown cross-neutralisation of two Australian elapid venoms, tiger snake (Notechis scutatus) and brown snake (Pseudonaja textilis) venoms, by their respective monovalent antivenoms. In this study enzyme immunoassays were used to quantify the amount of monovalent antivenom (quantity of monovalent antibodies to a specific snake venom) in vials of commercially produced antivenom in Australia. All antivenoms tested appeared to be polyvalent and contain varying amounts of all five terrestrial snake monovalent antibodies based on their binding to the five representative venoms. Redback spider antivenom did not have any measurable binding affinity for any of the five snake venoms, showing that the observed binding is not due to non-specific interactions with equine protein. The antivenoms had expiry dates over a 15 year period, suggesting that the antivenoms have been mixtures for at least this time. This study cannot be used to rationalise hospital stocks of antivenom in Australia because there is no guarantee that the antivenoms will remain as mixtures. However, it would be possible for the manufacturer to reduce the number of types of snake antivenoms available in Australia to two polyvalent antivenoms which would simplify treatment of snakebite.
Keywords antivenom
venom
snake bite
envenoming
cross-neutralisation
DOI http://dx.doi.org/10.1016/j.toxicon.2009.04.004   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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