**1. Introduction**

Snakebite envenomation is a relatively uncommon but serious medical emergency in Martinique, an overseas region of France with a population of 386,000 inhabitants, located in the Lesser Antilles of the Eastern Caribbean. Approximately thirty cases are declared every year. Envenomation is due to *Bothrops lanceolatus* (Order: Squamata; suborder: Serpentes; family: Viperidae; subfamily: Crotalinae; Figure 1), the only venomous snake in this Caribbean French territory and a snake not found elsewhere in the world [1]. This envenoming is known to be responsible for a high rate of multiple systemic thrombotic events as well as for possible local infectious complications.

**Figure 1.** *Bothrops lanceolatus* from Martinique, known as trigonocéphale or fer-de-lance is one the most dangerous venomous snakes in the Caribbean. (Photo courtesy of Mr. Michel Tanasi, a member of the snake working group).

As suggested by previous observations at the bedside [2,3], bacterial infection from snakebites in Martinique occurs in about one third of the envenomed cases, mainly in the most severely envenomed patients (grade II or III). Interestingly, local infection was hypothesized to be caused by the oral and fang microbiota of *B. lanceolatus*.

The oral microbiota of snakes comprises a wide range of aerobic and anaerobic microorganisms, including *Enterobacteriaceae* (*Morganella* spp. and *Escherichia coli*), *Streptococcus* spp., *Aeromonas* spp., *Staphylococcus aureus*, and *Clostridium* spp., as reported in several observational studies from snakebites worldwide [4–9]. However, the predominant microorganisms change according to the geographic region and environmental conditions. Additionally, bacteria susceptibility to beta-lactams, the most frequently used antibiotics to treat snake-envenomed patients, varies with possible resistant phenotypes, especially since the emergence of multidrug-resistant bacteria in the environment during the last years.

Therefore, we designed an experimental study aiming to identify the main bacterial microbiota from *B. lanceolatus* oral cavity. Then, based on the nature and susceptibility of the isolated bacteria to beta-lactams, our objective was to propose the most adequate preemptive antibiotic therapy that should be administered in the suspicion of infection in *B. lanceolatus*-bitten patients in Martinique.
