• Jason B Hack, Kori L Brewer, and William J Meggs.
• Division of Medical Toxicology, United States of America; Department of Emergency Medicine, East Carolina University, Greenville, NC 27858, United States of America. Electronic address: Hackj20@ecu.edu.
• Am J Emerg Med. 2023 Nov 1; 73: 171917-19.

AbstractThe definitive treatment of North American crotalid snakebites is antivenin. In 2000, an FabAV antivenom (CroFab®) was introduced and in 2022, F(ab')2AV (Anavip®) was approved for treatment of copperhead bites. Our center that sees primarily copperhead snake bites added the recently approved treatment as a second option for the 2022 snake bite season. This brief report we describe our initial experience with the two antivenins via retrospective chart review: the cost, charge, laboratory differences, response to therapy, complications and duration of hospitalization of admitted patients with copperhead envenomation. Using three independent reviewers in this IRB exempt report we found 31 patients with copperhead bites (7 exclusions) leaving 19 adults and 7 children for analysis. We found there was no difference in age, sex, presence of lab abnormalities, total vials administered, or length of stay. There was significant differences in hospital costs and charges to the patient. Future research should include multi-center experiences comparing the two antivenins.Copyright © 2023 Elsevier Inc. All rights reserved.

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