Volume 94, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



A total of 112 cases of envenomation were examined at two referring hospitals: Taichung Veterans General Hospital in central Taiwan and Taipei Veterans General Hospital (VGH-TP) in northern Taiwan. Overall, 77% (86/112) of cases developed clinically suspected wound infections and 54% (61/112) required surgery secondary to tissue necrosis, finger or toe gangrene, and/or necrotizing fasciitis. was the most abundant gram-negative bacterial strain isolated from bite wounds, followed by spp., , , and spp. in descending order; spp. were the most common gram-positive bacteria and spp. were the only anaerobic bacteria. A few episodes of bacteremia were caused by and spp. There were no significant variations in the distribution of bacterial species between these two hospitals except for a higher incidence of , spp., and polymicrobial infection observed at VGH-TP, which may have been related to variations in the fecal flora of prey and oral flora of individual snakes in different geographic areas in Taiwan. According to the susceptibility test involving various pathogens, first-line drug options for the management of snakebite wound infections may include monotherapy with ureidopenicillin or combination therapy with aminopenicillin and a third-generation cephalosporin or fluoroquinolone. A prospective evaluation of empiric antibiotic therapy for the management of snakebite should be considered.


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  • Received : 13 Sep 2015
  • Accepted : 29 Jan 2016

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