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Tiger snake (Notechis spp) envenoming: Australian Snakebite Project (ASP-13)

To the Editor: In their recent research paper, Isbister and colleagues questioned the clinical value of the CSL snake venom detection kit (sVDK) and the current approved dosing recommendations for CSL tiger snake antivenom (TSAV).1

They highlight five cases with a reported incorrect sVDK result for detection of brown snake rather than tiger snake venom. sVDK efficacy was not an end point of the trial and the methodology of how the kit was applied by the researchers was not described. Hence it remains unclear if a consistent collection approach was used by the researchers. Such variables can have a significant impact on conclusions.

The sVDK undergoes rigorous quality assurance testing and must meet batch release specifications before distribution. Data on sVDK specificity and sensitivity have been published supporting the robustness of the kit results when used as recommended.2 Training in the use of the sVDK is essential, and CSL conducts regular education sessions to optimise operator understanding and use of the kit.

Importantly, sVDK results should not be used in isolation in the clinical management of snakebite envenoming. Positive…