{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T02:08:58Z","timestamp":1784772538166,"version":"3.55.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>There are 7000\u20138000 venomous snake bites annually in the USA. Antibiotics are commonly administered to bite victims because infection is difficult to differentiate from local tissue injury following envenomation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The Arizona Poison and Drug Information Center (APDIC) in Tucson oversees antivenom administration for 14 Arizona counties. Records (1999\u20132021) were searched for antibiotic use and confirmed infections after a rattlesnake bite.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 4160 calls to APDIC regarding rattlesnakes. After excluding bites to animals, \u2018dry bites\u2019, prisoners and records with missing data, 2059 records were evaluated. Systemic antibiotics were administered to 206 patients (10% of bite victims). Twenty patients (0.97%) had confirmed infections, including cellulitis (n=10), fasciitis (n=4), abscess (n=3) and osteomyelitis (n=3). Five of the victims had positive blood cultures. The presence of tissue necrosis, leukocytosis, fever and elevated fibrinogen levels did not discriminate between toxic effects of venom and infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Confirmed infections following a rattlesnake bite are uncommon (0.97% of bites). Physicians should refrain from prescribing antibiotics, as they are not justified for most rattlesnake bite victims and the variety of pathogens encountered precludes use of any single effective antibiotic.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/trstmh\/trae044","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T23:26:52Z","timestamp":1722295612000},"page":"152-157","source":"Crossref","is-referenced-by-count":6,"title":["Infections following rattlesnake envenomation and use of antibiotics"],"prefix":"10.1093","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4488-4525","authenticated-orcid":false,"given":"Stephen A","family":"Klotz","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey T","family":"Smelski","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Arizona Poison Control and Drug Information Center, University of Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A","family":"Watkins","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, West Texas Regional Poison Center, Texas Tech University Health Sciences Center at El Paso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F Mazda","family":"Shirazi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Arizona Poison Control and Drug Information Center, University of Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,7,29]]},"reference":[{"issue":"3","key":"2025020409215210300_bib1","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1093\/clinids\/14.3.633","article-title":"Bite wounds and infection","volume":"14","author":"Goldstein","year":"1992","journal-title":"Clin Infect Dis"},{"issue":"5","key":"2025020409215210300_bib2","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1093\/infdis\/140.5.818","article-title":"Bacteriology of rattlesnake venom and implications for therapy","volume":"140","author":"Goldstein","year":"1979","journal-title":"J Infect Dis"},{"issue":"11","key":"2025020409215210300_bib3","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1016\/j.amjmed.2018.06.006","article-title":"Prophylactic antibiotics are not needed following rattlesnake bites","volume":"131","author":"August","year":"2018","journal-title":"Am J Med"},{"issue":"5","key":"2025020409215210300_bib4","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/0736-4679(93)90313-V","article-title":"The incidence of wound infection following crotalid envenomation","volume":"11","author":"Clark","year":"1993","journal-title":"J Emerg Med"},{"issue":"4","key":"2025020409215210300_bib5","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/S0736-4679(02)00563-2","article-title":"Antibiotics after rattlesnake envenomation","volume":"23","author":"LoVecchio","year":"2002","journal-title":"J Emerg Med"},{"key":"2025020409215210300_bib6","article-title":"Venomous snakes","author":"National Institute for Occupational Safety and Health"},{"issue":"4","key":"2025020409215210300_bib7","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1053\/j.tcam.2013.09.008","article-title":"Additional observations and notes on the natural history of the prairie rattlesnake (Crotalus viridis) in Colorado","volume":"28","author":"Fitzgerald","year":"2013","journal-title":"Top Companion Anim Med"},{"issue":"3","key":"2025020409215210300_bib8","doi-asserted-by":"crossref","first-page":"e0240821","DOI":"10.1128\/spectrum.02408-21","article-title":"Bacterial adaptation to venom in snakes and arachnida","volume":"10","author":"Esmaeilishirazifard","year":"2022","journal-title":"Microbiol Spectr"},{"issue":"4","key":"2025020409215210300_bib9","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1111\/vec.12337","article-title":"Prospective evaluation of the incidence of wound infection in rattlesnake envenomation in dogs","volume":"25","author":"Carr","year":"2015","journal-title":"J Vet Emerg Crit Care (San Antonio)"},{"issue":"2","key":"2025020409215210300_bib10","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/S0196-0644(05)80207-0","article-title":"Nonvenomous snakebite in Massachusetts: prophylactic antibiotics are unnecessary","volume":"22","author":"Weed","year":"1993","journal-title":"Ann Emerg Med"},{"key":"2025020409215210300_bib11","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.toxicon.2017.04.015","article-title":"Dry bite\u201d in venomous snakes: a review","volume":"133","author":"Naik","year":"2017","journal-title":"Toxicon"},{"issue":"7","key":"2025020409215210300_bib12","first-page":"680","article-title":"Incidence of delayed and recurrent coagulopathies following rattlesnake envenomation in patients initially treated with rattlesnake antivenom","volume":"53","author":"Karpen","year":"2015","journal-title":"Clin Toxicol"},{"issue":"1","key":"2025020409215210300_bib13","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1093\/infdis\/164.1.195","article-title":"Antibacterial activity of crotalid venoms against oral snake flora and other clinical bacteria","volume":"164","author":"Talan","year":"1991","journal-title":"J Infect Dis"},{"key":"2025020409215210300_bib14","doi-asserted-by":"crossref","first-page":"4003","DOI":"10.2147\/IDR.S269719","article-title":"Plasma fibrinogen as a diagnostic marker of infection in patients with nonunions","volume":"13","author":"Wang","year":"2020","journal-title":"Infect Drug Resist"}],"container-title":["Transactions of The Royal Society of Tropical Medicine and Hygiene"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/trstmh\/article-pdf\/119\/2\/152\/58676346\/trae044.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/trstmh\/article-pdf\/119\/2\/152\/58676346\/trae044.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T09:22:03Z","timestamp":1738660923000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/trstmh\/article\/119\/2\/152\/7723274"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,29]]},"references-count":14,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,7,29]]},"published-print":{"date-parts":[[2025,2,4]]}},"URL":"https:\/\/doi.org\/10.1093\/trstmh\/trae044","relation":{},"ISSN":["0035-9203","1878-3503"],"issn-type":[{"value":"0035-9203","type":"print"},{"value":"1878-3503","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2024,7,29]]}}}