{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T18:02:27Z","timestamp":1785261747345,"version":"3.55.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0014274","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000}}],"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rabies is almost universally fatal once symptoms develop but is preventable through timely post-exposure prophylaxis (PEP). Global shortages of human and equine rabies immunoglobulin (RIG) have led the World Health Organization to recommend human monoclonal antibodies (mAbs) as acceptable alternatives. Comparative real-world data on single-antibody versus two-antibody cocktail mAbs are limited, particularly from endemic, resource-limited settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comparative observational study was conducted in a high-volume rabies PEP clinic in India between October 2021 and December 2022. Consecutive patients with category III animal exposures received either a single human anti-rabies mAb (Rabishield; n\u2009=\u2009159) or a two-mAb cocktail (Twinrab; n\u2009=\u2009159) in combination with WHO-recommended vaccine. Primary outcomes included safety, ease of administration, and operational feasibility. Data were analysed using independent t-tests and chi-square or Fisher\u2019s exact tests, with p\u2009&lt;\u20090.05 considered significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean age was 29.7\u2009\u00b1\u200919.4 years in the Rabishield group and 32.8\u2009\u00b1\u200920.4 years in the Twinrab group. Ease of infiltration was rated \u201ceasy\u201d in 66.7% versus 62.9% of patients (p\u2009=\u20090.63). Local adverse events were uncommon, with pain reported in 2.5% versus 7.5% (p\u2009=\u20090.07) and erythema in \u2264 1.3% of participants. No serious systemic adverse events occurred. Rabishield required more vials per patient (2.28\u2009\u00b1\u20090.84 vs 2.00\u2009\u00b1\u20090.69; p\u2009=\u20090.001) and had a higher mean infiltration volume (4.7\u2009\u00b1\u20091.9 mL vs 4.0\u2009\u00b1\u20091.6 mL; p\u2009&lt;\u20090.001), while wastage was similar between groups (1.03\u2009\u00b1\u20090.72 mL vs 1.03\u2009\u00b1\u20090.69 mL; p\u2009=\u20090.95).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both single and cocktail human anti-rabies mAbs were safe, well tolerated, and operationally feasible in a programmatic setting. The slightly higher volume and vial requirement for Rabishield may have cost and logistics implications. These findings support broader mAb adoption to address RIG shortages in rabies-endemic, resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014274","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T19:15:36Z","timestamp":1784834136000},"page":"e0014274","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety and operational feasibility of single versus cocktail rabies monoclonal antibodies for post-exposure prophylaxis in a resource-limited setting"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6271-5341","authenticated-orcid":true,"given":"Nidhi","family":"Fotedar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haradanahalli 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