Second Dose of Scorpion Antivenom in Children with Indian Red Scorpion (Mesobuthus tamulus) Sting Envenomation

ABSTRACT

Objective: To study the effect of the second dose of scorpion antivenom in children with nonresolving or worsening scorpion sting envenomation. Methods: 72 children aged ?12 yearswith scorpion sting envenomation grade 2 and above were enrolled. 61 received the first doseof three vials of antivenom at admission (group A). Children with persistent/worseningenvenomation within 6 hours received the second dose (group B). The time required forresolution of autonomic symptoms, myocardial dysfunction, predictors of the second doseand side effects were studied. Results: The mean time taken for resolution of autonomicsymptoms were comparable in Group A and B (4.1 vs. 5.3 h, P=0.4), and of myocardialdysfunction was shorter in Group A (10.8 vs. 37.6 h, P=0.02). On regression analysis,abnormal echocardiography at admission was found to be a significant predictor of thesecond dose (OR=27.6, 95% CI, 4.7–162.5; P=<0.001). Conclusion: Children with severescorpion sting envenomation with abnormal echocardiography may require a higher dose ofscorpion antivenom. Trial registration CTRI/2015/03/005652.