12 hours after Initial Control achieved

2.4 ± 1.1**

2.4 ± 1.2**

* No change or a decline in the Efficacy Score was considered an indication of clinical response and a sign of efficacy.

** For both the Scheduled and the PRN Groups, differences in the Efficacy Score at the four post-baseline assessment times were statistically decreased from baseline by Friedman†s test (p<0.001).

In published literature accounts of rattlesnake bites, it has been noted that a decrease in platelets can accompany moderately severe envenomation, which whole blood transfusions could not correct [3].These platelet count decreases have been observed to last for many hours and often several days following the venomous bite [3,4,5].In this clinical study,6 patients had pre-dosing platelet counts below 100,000/mm³ (baseline average of 44,000/mm³).Of note, the platelet counts for all 6 patients increased to normal levels (average 209,000/mm³) at 1 hour following initial control dosing with CroFab (see Figure 1).

Although there was no significant difference in the decrease in ES between the two treatment groups, the data suggest that Scheduled dosing may provide better control of envenomation symptoms caused by the continued leaking of venom from depot sites. Scheduled patients experienced a lower incidence of coagulation abnormalities at follow-up compared with PRN patients (see Table 5 ). In addition, the need to administer additional CroFab to patients in the PRN Group after initial control suggests that there is a continued need for antivenin for adequate treatment.

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