I would like to make a few comments regarding a recent article(1). The current recommendation for neurotoxic envenomation irrespective of age is to administer an initial dose of 10 vials of ASV over one hour. A trial of neostigmine is then given and the child is monitored. A second and final dose of 10 vials of ASV is administered 1-2 hours later if there is no improvement or worsening of symptoms(2,3). There is no justification for using 50 vials. I would also like to highlight the fact that the first dose of 10 vials of ASV is preferably given over 1 hour. There is no benefit in administering each dose over a longer period.