Snake bites poisoning is considered as one of the most common causes of death in
Saudi Arabia annually. This study aimed to evaluate the efficacy of administration of
high doses of anti-snake venom (ASV) versus low doses in adult patients with severe
Viperidae envenoming. Cases were collected retrospectively from Dammam
poisoning center, Saudi Arabia throughout the years: 2010 and 2012. Low doses
treatment regimen was followed in year 2010 where A total 4 to 6 vials of ASV are
given distributed , while, in year 2012, high doses treatment regimen was followed in
which the patients were given an initial infusion of 5 to 10 vials. These two methods
were compared based on efficacy, number of vials, and complications. Data of 150
patients were collected, 114(76%) of the recruited patients were males and 36(24%)
were females. The incidence rate of coagulopathy, and the need for packed RBCs
was significantly less in high ASV doses in comparison to low doses (P=0.002 and
P=0.02, respectively).The high doses of ASV appear to be safe and effective against
the coagulopathy complications in severe snakes envenoming. This study concluded
that patients with severe viperidae snake envenoming are preferred to receive high
ASV doses to neutralize the circulating venom, and lower the occurrence of serious
complications. The study recommend administration of 5-10 vials of ASV as an initial
dose in severe snake envenoming is essential