Route of administration of redback spider bite antivenom: Determining clinician beliefs to facilitate Bayesian analysis of a clinical trial

  title={Route of administration of redback spider bite antivenom: Determining clinician beliefs to facilitate Bayesian analysis of a clinical trial},
  author={Simon G. A. Brown and G. Isbister and B. Stokes},
  journal={Emergency Medicine Australasia},
Objective:  To determine current beliefs of Australasian emergency physicians, to form the basis of ‘stopping rules’ for a clinical trial of intravenous (i.v.) versus intramuscular (i.m.) redback spider antivenom. 
A randomised controlled trial of intramuscular vs. intravenous antivenom for latrodectism--the RAVE study.
The difference between IV and IM routes of administration of widow spider antivenom is, at best, small and does not justify routinely choosing one route over the other and may provide no benefit over placebo. Expand
Randomized controlled trial of intravenous antivenom versus placebo for latrodectism: the second Redback Antivenom Evaluation (RAVE-II) study.
The addition of antivenom to standardized analgesia in patients with latrodectism did not significantly improve pain or systemic effects. Expand
Venomous animals: clinical toxinology.
Medical treatment for venomous snakes is available only for a limited range of species, not for all dangerous species, is in short supply in some areas of highest need, and in many cases, is supported by historical precedent rather than modern controlled trials. Expand
Antivenom Efficacy in Neutralizing Histopathological Complications Following Latrodectus dahli Envenomation
Specific antivenom injection, 24h after the venom injection, could protect the tissues from incidence and intensification of histopathological complications, and future studies in human beings should be conducted to assess the protection against the specific-Latrodectus antivenin. Expand
Severe verapamil intoxication despite correct use of low-dose verapamil
Different factors in this patient that could have precipitated this event such as diminished metabolism by cytochrome P450 iso-enzymes, a slightly diminished renal function with hypoalbuminemia, and interaction with other protein-binding drugs are found. Expand


Latrodectism: a prospective cohort study of bites by formally identified redback spiders
The spectrum of severity and early diagnostic predictors of redback spider bites are determined and the effect of intramuscular redback antivenom is examined. Expand
A double‐blind, randomized trial of intravenous versus intramuscular antivenom for Red‐back spider envenoming
Objective:  To compare the efficacy of intravenous versus intramuscular antivenom (AV) in the treatment of Red‐back spider (RBS) envenoming.
Failure of intramuscular antivenom in Red-back spider envenoming.
Four cases of Red-back spider envenoming are reported in which there was minimal response to intramuscular antivenom, raising the question of its efficacy. Expand
Antivenom Treatment in Arachnidism
Until controlled trials of antivenoms in systemically envenomated patients are undertaken, antivenom use appears justified in severe envenOMation. Expand
Envenoming and antivenom use in Australia.
  • J. White
  • Medicine
  • Toxicon : official journal of the International Society on Toxinology
  • 1998
Red back spiderAntivenom is the most commonly used antivenom, with reports of usage being greater than for all other antivenoms combined, and clinical experience suggests only 20% of red back spider bites require antivenOM therapy. Expand
Survey of 2144 Cases of Red‐Back Spider Bites: Australia and New Zealand, 1963‐1976
An analysis has been made of 2144 consecutive cases of latrodectism (envenomation by the redback spider, Latrodectus mactans hasselti) reported to the Commonwealth Serum Laboratories, finding local pain, redness and swelling were the most common symptoms. Expand
  • S. Wiener
  • Medicine
  • The Medical journal of Australia
  • 1961
A comparison of the behaviour of the Black Widow and the Sydney Funnel-Web Spider over a period of several years shows that the former is more docile than the latter, and the latter is more aggressive. Expand
Reporting clinical research: An example of balancing a simple clinical message with data required to help future research
  • N. Buckley
  • Medicine
  • Emergency medicine Australasia : EMA
  • 2005
The science of medicine will only advance when researchers fearlessly present their data, and it is pseudoscientific to apply statistical tests to many hypotheses, especially to any ‘hypothesis’ derived after the experiment has been conducted. Expand
Monitoring of large randomised clinical trials: a new approach with Bayesian methods
Bayesian approach to monitoring of two randomised controlled trials in patients with lung cancer and head and neck cancer concluded that there was insufficient evidence to convert either sceptics or enthusiasts, and that the trials should remain open to recruitment. Expand
A case for Bayesianism in clinical trials.
  • D. Berry
  • Computer Science, Medicine
  • Statistics in medicine
  • 1993
This paper describes a Bayesian approach to the design and analysis of clinical trials, and compares it with the frequentist approach, noting the role of randomization is an important difference. Expand