Inappropriate antivenom use in Crotalus snakebite treatment reports: A national data-based analysis (2014-2024).

Snakebite envenoming by Crotalus snakes is a relevant public health problem in Brazil. From 2015 to 2024, 26,021 cases were reported in DataSUS, with 78,329 antivenom vials administered. However, only 27,257 vials had the specific antivenom type recorded, indicating 51,072 undocumented vials. In addition, the database records the administration of antivenoms that are not typically indicated for crotalic envenoming. Because these data originate from a secondary surveillance system, such discrepancies may reflect documentation gaps, data entry errors, or potential inconsistencies in antivenom selection. These findings highlight important limitations in national reporting systems and reinforce the need to strengthen clinical training, surveillance quality, and antivenom stewardship policies in Brazil.