Making antivenom treatment safer

Snakebite envenoming affects large numbers of people in rural Sri Lanka. For years, adverse reactions to antivenom were a barrier to safe treatment: the medicine that saves lives could itself cause severe harm.

The Kelaniya-RemediumOne partnership led a randomised, double-blind, placebo-controlled trial involving 1,000 patients across three centres. The trial tested low-dose adrenaline, promethazine and hydrocortisone, alone and in combination, to prevent acute adverse reactions to antivenom.

The findings directly informed the World Health Organization’s Guidelines for the Management of Snakebite, second edition, published in 2016. Treatment given in rural hospitals in Sri Lanka and beyond is safer as a result.

This was the trial with which the CTU began its work, and it set the pattern for everything that followed: a question that matters to patients in this country, answered to a standard that changes practice internationally.