It is made from animal sera, and adverse effects, including life threatening anaphylaxis, are common. The two authors applied the inclusion criteria, assessed trial quality, and extracted the data. We sought additional data from trialists where required. Routine prophylactic adrenaline for polyvalent antivenom known to have high adverse event rates seems sensible, based on this one trial. If clinicians believe local factors do not justify routine adrenaline, then they should test their belief in a randomised trial.
Antihistamine appears to be of no obvious benefit in preventing acute reactions from antivenoms.
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