Chippaux Jean-Philippe auteur aut IRD Lang J. auteur aut IRD Amadi Eddine S auteur aut IRD Fagot P. auteur aut IRD Rage V. auteur aut IRD Peyrieux J.C. auteur aut IRD Le Mener V. auteur aut IRD text journalArticle eng text/pdf reformatted digital access A large-scale clinical trial was conducted, according to World Health Organization Good Clinical Practice guidelines, in 7 centres in North Cameroon to determine the safety and efficacy of a polyvalent antivenom composed of purified F(ab')2. This study included 223 patients presenting clinically with an obvious snake bite, predominantly due to Echis ocellatus (viper), the most abundant species in this savannah region. Clinical surveillance was maintained for 5 d in all patients and until the twenty-sixth day in 74% of cases. Two 10 mL ampoules of polyvalent F(ab')2 equine antivenom (Ipser Africa (TM)) were administered to each patient by intravenous infusion. If necessary, treatment was repeated 1 h after the end of the first infusion, and then with a frequency determined by the patient's clinical condition. Before initiation of antivenom treatment, the main clinical disorders observed on admission were oedema (93.7%) and haemorrhage (48.9%), with a clotting time longer than 30 min in 65.4% of patients. Clincal cure was obtained in 213 patients (96.8%). No amputation was necessary, and the case fatality rate was only 1.3%. On average, 4.6 (+ or - 3.7) ampoules were administered per patient ; 43% of subjects recovered after only a single infusion of 2 ampoules. Early adverse reactions, of varying degrees of severity, were observed in 6.3% of patients. A severe early reaction, anaphylactic shock, was observed in only one patient (0.4%). Serum sickness was observed in another patient. Polyvalent F(ab')2 equine antivenom given by repeated 20 mL intravenous infusions is a safe and effective treatment for envenomation caused by African vipers. (Résumé d'auteur) specialized ESSAI CLINIQUE TRAITEMENT MEDICAL EFFICACITE VENIN SERPENT ENVENIMATION SEROTHERAPIE PROTOCOLE D'UTILISATION EFFET SECONDAIRE CAMEROUN NORD 050MEDECI 92 6 657-662 1998 0035-9203 https://www.documentation.ird.fr/hor/fdi:010017807 10.1016/S0035-9203(98)90802-1 0035-9203 [F B010017807] https://www.documentation.ird.fr/hor/fdi:010017807 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/pleins_textes_6/b_fdi_49-50/010017807.pdf IRD - Base Horizon / Pleins textes 1999-06-11 2020-08-03 fdi:010017807 fre