Scropifav Antivenom Versus Supportive Care Alone in the Treatment of Pediatric Scorpion Envenomation.

BACKGROUND

Scorpion envenomation is a significant public health concern in specific regions and can have severe consequences in pediatric patients. The efficacy of antivenom treatment remains controversial.

OBJECTIVE

To compare the clinical course and outcomes of pediatric scorpion envenomation in patients receiving SCORPIFAV antivenom versus supportive care alone.

METHODS

We conducted a retrospective study of children aged 0-18 years presenting with grade ≥2 scorpion envenomation to the pediatric emergency department at Soroka University Medical Center, Israel, between 2014 and 2020. Clinical outcomes were compared between patients who received SCORPIFAV and those treated with supportive care alone.

RESULTS

A total of 194 children were included (median age: 3 years, interquartile range: 2-8 years); 125 received SCORPIFAV and 69 received supportive care only. Patients treated with SCORPIFAV required less sedation (10.3% vs. 23.4%, P = 0.02), less analgesia (53.3% vs. 81.3%, P < 0.001), and fewer antihypertensive medications (0% vs. 17.2%, P < 0.001). SCORPIFAV administration was associated with higher odds of requiring minimal additional treatment (OR = 2.568, 95% CI, 1.168-5.646, P = 0.019). No significant differences were found in pediatric intensive care unit admission rates or length of stay.

CONCLUSIONS

In pediatric patients with grade ≥2 scorpion envenomation, SCORPIFAV use was associated with reduced need for sedatives, analgesics, and antihypertensive medications. These findings suggest that early administration of SCORPIFAV in the emergency setting may help attenuate the sympathetic response and reduce overall treatment intensity.