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Treatment of Hymenoptera Reactions: Acute and Prophylactic

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Stinging Insect Allergy

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Abstract

Systemic reactions to insect stings are reported by up to 3% of adults and 1% of children. At least 50 fatal reactions occur from anaphylaxis to insect stings each year in the United States. The risk of another systemic reaction is estimated at 30–60% depending upon the severity of the previous sting reaction. Patients should avoid stings, have injectable epinephrine available to treat a systemic reaction if it occurs, and be referred to an allergist for evaluation, venom testing, and to determine if they should start venom immunotherapy. Venom immunotherapy is 80–98% effective in completely preventing recurrent systemic reactions to insect stings. This chapter provides information about patient selection, venom selection, mechanism of action, safety, maintenance interval, and monitoring of venom immunotherapy. Treatment of an insect sting reaction consists of immediate therapy to control the current symptoms of the local or systemic reaction as well as education and planning to prevent future insect stings and reactions.

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  1. Department of Asthma and Allergic Diseases, Park Nicollet Clinic, Minneapolis, MN, USA

    David F. Graft M.D.

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  1. David F. Graft M.D.
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Correspondence to David F. Graft M.D. .

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  1. San Antonio Allergy and Asthma Clinic, San Antonio, Texas, USA

    Theodore M. Freeman

  2. Allergy, Asthma & Immunology Associates P.C., Omaha, Nebraska, USA

    James M. Tracy

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Graft, D.F. (2017). Treatment of Hymenoptera Reactions: Acute and Prophylactic. In: Freeman, T., Tracy, J. (eds) Stinging Insect Allergy. Springer, Cham. https://doi.org/10.1007/978-3-319-46192-2_7

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