ULTRARUSH-IMMUNOTHERAPY WITH HYMENOPTERA VENOMS

The initiation of hymenoptera venom immunotherapy usually requires a h ospital stay from 3 - 5 days (rush protocol) or weekly injections duri ng 3 - 4 months (ambulant protocol). Recently Birnbaum et al. [2] desc ribed a protocol which shortens this initiation phase to 3,5 hours. To evaluate this protocol we treated 56 honeybee venom allergic patients and 70 vespula venom allergic patients with a case history of moderat e to severe systemic reactions (Grade II - IV) and a positive skin tes t and/or specific serum IgE antibodies as follows (ultrarush protocol) : On the first day a cumulative dose of 111,1 mu g was administered un der intensive care conditions. Further injections were given on day 8 (2 x 50 mu g with an interval of 30 minutes), on day 22 (100 mu g) and thereafter at intervals of 4 weeks (100 mu g per injection). We compa red the ultrarush protocol with conventional protocols (rush, ambulant ) regarding efficacy and safety. The ultrarush protocol was shown to b e a safe, effective and economic method to initiate hymenoptera venom immunotherapy. Regarding efficacy and safety there was no difference b etween the 3 protocols, and the treatment with vespula venom was super ior to that with honeybee venom in each of the 3 protocols.