PREVENTION AND TREATMENT OF HYMENOPTERA VENOM ALLERGY

SUMMARY After a systemic allergic reaction, the use of an emergency medical kit should clearly explained to the patient. I.m. injected epinephrine is the treatment of choice for acute anaphylaxis. Venom immunotherapy (VIT) is indicated both in children and adults with a history of severe systemic reactions and documented sensitisation to the respective insect. As for systemic, non life-threatening reactions other factors may influence the decision to initiate VIT. The efficacy of VIT was demonstrated in three prospective controlled and a number of prospective uncontrolled studies. Most patients with mild to moderate anaphylactic symptoms and positive skin tests remain protected even years after VIT lasting three to five years has been discontinued. Longer term or lifelong treatment should be considered in high-risk patients.