High mortality due to snakebites in French Guiana: Time has come to re-evaluate medical management protocols

[...]the demonstration of the effectiveness of an AV in a given territory does not guarantee the effectiveness in others places, even close, as studies have been performed in South America, specifically in Brazil, Colombia and Ecuador [10–12], comparing different national AVs, which showed efficacy of AV therapy in patients submitted to treatment with AVs manufactured with venoms from no Guianese species. [...]although tolerance of AV remains an issue,—the side effects ranging from mild allergic reactions to anaphylactic shock—recent improvements in AV manufacturing allow significant reduction in both their incidence and severity, which can be easily controlled by symptomatic treatment. [...]although many factors influence the variability of the venoms [16], some experimental and clinical studies showed that polyvalent AVs exhibit quite good paraspecificity and cover most of Amazonian species [10, 17]. [...]improvements of AV manufacturing (purification of IgG in all marketed AV, enzymatic digestion of antibodies in most marketed AV, and lack of chemical preservative in lyophilized AV) has made the AV much safer and has dramatically reduced adverse events [18].