Letters Snake bite

Problems with treating snake bite in India

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i103 (Published 14 January 2016) Cite this as: BMJ 2016;352:i103
  1. Soumyadeep Bhaumik, medical doctor1
  1. 1Liverpool L3 8AF, UK
  1. drsoumyadeepbhaumik{at}gmail.com

Venkatesh and colleagues’ suggest that India has a successful model for treating snake bite, but this is not true.1 2

Firstly, the two management protocols they cite were not universally taken up and different protocols with different dosing and indications for antivenom are used.3 4 The authors then contradict themselves by citing an article on a locally developed management protocol as a proof of rational use of antivenom guided by management protocols.5 This local management protocol has been superseded by the West Bengal government’s snakebite management guidelines, and the two differ on several counts.

Secondly, despite increased demand due to greater access to healthcare services, since 2013 when price control was introduced, the availability of antivenom has decreased because manufacturers have less motivation to produce it. Centres across India face the problem of antivenom non-availability.6 7 8 The Central Research Institute, a leading producer of antivenom, has scaled down production massively.9

I hope that an Indian model is developed that can be used globally. Much needs to be done for snakebite patients, who lack a political voice,3 and it should begin with accepting, not denying the problems.


Cite this as: BMJ 2016;352:i103


  • Competing interests: My travel and accommodation for the protocol development workshop for National Snakebite survey was funded by the South Asian Cochrane Network and Centre at Christian Medical College, Vellore, in 2013.


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