PD48 Dosing Variability Of Anti-Scorpionic Serum In Brazil - A Call For Standardization - Study Summary

Sep 29, 2026

Brazil faces frequent Tityus scorpion accidents, yet anti-scorpionic serum dosing lacks consensus. A scoping review synthesized Brazilian studies using PRISMA-ScR and assessed bias with ROBINS-I, including traffic-light visualization. Five studies (from 410 records) reported wide vial ranges for mild, moderate, and severe cases, often without risk classification and with high bias driven by insufficient control of confounding. Evidence showed treatment volumes frequently exceeding Ministry of Health guidance, increasing waste and safety concerns. Educational initiatives and clinical audits are recommended to standardize rational use.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages1

Reading Time3 min

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Introduction

Methods

Results

Conclusions

PD48 Dosing Variability Of AntiScorpionic Serum In Brazil: A Call For Standardization Amanda das Dores, Stéfani Borges ( [borgestefani@gmail.com](borgestefani@gmail.com)), Bruna Santos and Daniela Melo Introduction: Accidents involving scorpions of the Tityus genus are common in Brazil. While there is no consensus on the ideal dose of anti-scorpionic serum, its use is not recommended for mild cases, whereas two to four vials are suggested for moderate cases and four to six vials for severe cases. Our objective was to synthesize the available literature on serum dosage in Brazil. Methods: A scoping review was conducted of Brazilian studies on patients with suspected or confirmed scorpion envenomation that described serum dosages used for treatment (protocol registered on Open Science Framework DOI 10.17605/OSF.IO/8F7ZB). The study followed the PRISMA Extension for Scoping Reviews guidelines. The ROBINS-I tool was used for risk of bias assessment, with a traffic light plot generated using the Robvis app. Data collection and analysis were performed by two independent reviewers, with a third reviewer consulted when necessary. Results: After screening 410 records, five studies were included. One study reported using 7.5 (standard deviation [SD] 3.5) vials for mild cases, 4 .0 (SD 1 .7) for moderate, and 6 .5 (SD 2 . 1) for severe cases. Another study described one to 10 vials for mild cases, one to 15 for moderate, and one to 20 for severe cases. Other studies report using one to six vials, four vials, or that most patients received no more than four vials, although none of these studies provided the risk classification. All studies presented a high risk of bias, mainly due to lack of control for confounding variables. Conclusions: Available data on anti-scorpionic serum use in Brazil revealed significant variability in clinical management, with the volumes administered often exceeding the Ministry of Health’s recommendations. This highlights a lack of standardization, which increases the likelihood of resource waste in the health care system and safety concerns. Strategies such as educational initiatives and clinical audits are recommended to promote rational serum use. PD50 Certainty Of Evidence Assessment Of The BRIGHTE Study: Fostemsavir In The Treatment Of Multidrug-Resistant HIV-1 Marina Silva, Isabela Rossi, Lívia Nassif, Roberto Júnior, Ludmila Gargano, Juliana Alvares-Teodoro, Francisco Acurcio and Augusto Guerra Júnior ([augustoguerrajr@ufmg.br](augustoguerrajr@ufmg.br)) Introduction: The BRIGHTE study assessed the efficacy of fostemsavir tromethamine 600 mg with optimized background therapy in adults with multidrug-resistant HIV-1 and virological failure. Participants were divided into a randomized cohort, comparing fostemsavir with placebo, and an observational cohort. After eight days, all randomized participants switched to fostemsavir. This study evaluated the certainty of evidence from the BRIGHTE trial. Methods: The GRADEpro tool was used to assess the quality of evidence. Five studies related to BRIGHTE were included, covering follow-up assessments at eight days (randomized phase) and 48, 96, and 240 weeks (observational phase) . The outcomes assessed included changes in viral load, adverse events, virological response and failure, changes in CD4+ T cell count from baseline, mortality, quality of life, and treatment adherence. Differences between the randomized and observational phases were evaluated, focusing on the impact of this transition on evidence quality. Results: Transition to the observational phase compromised methodological robustness, increasing the risk of bias. In the randomized phase, evidence quality was reduced by the lack of details on the randomization process and uncertainties regarding double blinding. In the observational phase, confounding bias arose mainly due to intervention classification and the absence of an active comparator, hampering the assessment of fostemsav

FAQs

What dosing variability exists for anti-scorpionic serum in Brazil?

Included Brazilian studies reported broad vial ranges across mild, moderate, and severe cases, with some mild regimens as low as 7.5 vials and others extending up to 10 vials, while severe cases reached up to 20 vials in certain reports.

How was evidence quality and bias assessed in the review?

The review used PRISMA Extension for Scoping Reviews, ROBINS-I for risk of bias assessment, and traffic-light visualization generated via the Robvis app, with data selection and analysis performed by two independent reviewers.

Why do the authors recommend standardization, and what interventions are suggested?

Because administered volumes often exceeded Ministry of Health recommendations, the review highlights lack of standardization that can increase resource waste and safety concerns. Educational initiatives and clinical audits are proposed to promote rational serum use.

Sep 29, 2026

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