DURATION OF VENOM IMMUNOTHERAPY - RELATIONSHIP TO THE SEVERITY OF SYMPTOMS OF INITIAL INSECT STING ANAPHYLAXIS

Background: This study assessed the postulate that the adequate durati on of venom immunotherapy (VIT) is related to the seventy of the initi al sting anaphylactic symptoms. Methods: Data were collected from pati ents with venom allergy who had sting anaphylaxis and subsequent posit ive venom skin test results, received maintenance VIT, and had field r e-stings after cessation of VIT. There were 217 re-stings in 113 patie nts with 15 systemic reactions in 10 patients (a re-sting reaction rat e of 9% per sting and 7% per patient). Results: Re-sting reactions occ urred in 1 of 25 patients with initial mild anaphylaxis (4%), 2 of 41 patients with moderate reactions (5%), and 7 of 47 patients with initi al severe symptoms (15%). The results were not influenced by the durat ion of VIT or the interval between cessation of VIT and the re-sting. Eighteen patients who converted to negative skin test reactions had no reactions when re-stung Conclusions: These results suggest a relation ship between the severity of anaphylaxis and subsequent duration of VI T Two to three years is sufficient for patients who had mild to modera te anaphylaxis. Longer duration of therapy is advisable for patients w ho had severe symptoms and continue to have positive venom skin test r esults.