In reply: We note incorrect assertions in the comments by Isbister and colleagues regarding our article on single vial antivenom recommendations for elapid envenoming in Australia.1
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- 1. Weinstein SA, Mirtschin PJ, White J. Risks and realities of single vial antivenom recommendations for envenoming by Australian elapid snakes. Med J Aust 2019; 211: 492–493. https://www.mja.com.au/journal/2019/211/11/risks-and-realities-single-vial-antivenom-recommendations-envenoming-australian.
- 2. Johnston CI, Ryan NM, Page CB, et al. The Australian Snakebite Project, 2005–2015 (ASP‐20). Med J Aust 2017; 207: 119–125. https://www.mja.com.au/journal/2017/207/3/australian-snakebite-project-2005-2015-asp-20.
- 3. Sackett DL, Rosenberg WM, Gray JA, et al. Evidence based medicine: what it is and what it isn't. BMJ 1996; 312: 71–72.
- 4. Mirtschin PJ, Rasmussen AR, Weinstein SA. Australia's dangerous snakes: biology, identification and envenoming. Melbourne: CSIRO Publishing, 2017.
- 5. Villalta M, Sánchez A, Herrera M, et al. Development of new polyspecific antivenom for snakebite envenoming in Sri Lanka: Analysis of its preclinical efficacy as compared to a currently available antivenom. Toxicon 2016; 122: 152–159.
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Julian White provides advice to Seqirus, manufacturer of antivenoms used in Australia, as part of a contract between his employing hospital and Seqirus. He occasionally receives travel support to attend toxinology meetings from Seqirus. However, he does not receive any financial remuneration or other compensation from Seqirus, and Seqirus has no role, input or influence on any of his reports, clinical practice or comments. He also provided an invited opinion in the referenced coronial cases. Peter Mirtschin provided independent commentary included in the coronial reports and is owner of Venom Supplies in the Barossa Valley, SA, a business that is leased to others; this business occasionally conducts business with Seqirus, but he has no input into, and does not receive any financial remuneration or other compensation from, Seqirus.