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Warning against antivenom for redback bites
最近一位医学专家指出在处理红背蜘蛛咬伤时应慎用抗毒血清， 因为目前的资料显示所有蜘蛛致死的病例都来自另外一种更毒的蜘蛛---funnel web spider, 而目前还没有死于红背蜘蛛的例子。最新的研究表明和对照组相比，使用抗红背蜘蛛血清对疼痛等症状的改善没有显著的差异，而副作用却不低。
但他同时也指出对老人和孩子，医生应根据病情的严重程度决定要不要使用抗毒血清。
为辨别这两重剧毒蜘蛛，我贴了他们的照片。咬后剧烈的疼痛是一个重要的症状，可伴恶心，呕吐，心慌等，速去急诊。
A staff specialist in emergency medicine and clinical toxicologist at Westmead Hospital, Dr Mann believes the use of antivenom needs to be questioned in light of data that shows not one fatality in Australia can be solely attributable to a redback spider bite.
"I know this will be controversial but no one has ever died from a redback spider bite. They have from a funnel web spider, but not a red back," Dr Mann said.
"I am yet to administer any anti-venom for redback spider bites and there is only a very select few that I will consider using it on."
Dr Mann made the comments during a presentation at the Rural Doctor Live Seminar held in Sydney over the weekend.
He pointed out that a randomised controlled trial published last year in the Annals of Emergency Medicine journal by researchers at the University of Newcastle found that about two-thirds of patients who received antivenom did not experience a decrease in their pain levels.
"What the study also found was that in the placebo group in the trial, 23% said their pain was reduced. That's a large proportion. That raises questions on the efficacy of the antivenom and whether it is working," Dr Mann said.
"If someone comes into your GP clinic demanding that they want antivenom, show them the evidence that it likely does not work for most people."
Antivenom to treat red back bites could be useful in the elderly and in children depending on what other health conditions they may have, he added.
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