Maintenance venom immunotherapy.

PURPOSE OF REVIEW: Venom immunotherapy has proven to be a very effective method for the prevention of future re-sting reactions. However, initiation of the venom injection program is just the beginning. This review looks at recent papers which shed light on other issues that arise during maintenance venom immunotherapy.

RECENT FINDINGS: Prophylactic antihistamines taken before venom injections reduce the frequency of reactions and one report suggests that they may improve efficacy. The schedule of venom injections usually does not have to be adjusted for patients who develop local reactions; a very large reaction may be the exception. Patients who react to stings should have their maintenance doses increased. Most patients are able to extend the interval between injections to 8 weeks in the third year of treatment. Two groups have proposed a maintenance interval of 12 weeks for routine use.

SUMMARY: Our understanding of insect sting sensitivity continues to improve, leading to better outcomes for allergic patients.