Guidelines needed for physicians treating venom allergy

LOS ANGELES — A need for physician education is prompted by the remarkably low percentage of patients with systematic reactions to venom stings who saw an allergist and were prescribed self-injectable epinephrine, according to recent study findings presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.

“According to the latest practice parameter, referral to an allergist is appropriate for any patient who has had an allergic reaction to hymenoptera and is a potential candidate for immunotherapy,” researcher Priya J. Patel, MD, of Rutgers New Jersey Medical School, and colleagues wrote. “As a quality control measure, we determined whether physicians at our hospital followed this recommendation.”

Patel and colleagues examined 620 patients with a documented history of insect allergy, noting whether their reactions were systemic, local or unclear. Of those with systemic reactions, investigators determined whether or not epinephrine was prescribed for self-injection.

Results of the study showed that 61% of patients had a systemic reaction, 6% had a local reaction, and 33% were unclear. Fifty-three percent of those identified as having a systemic reaction were prescribed epinephrine; however, the prescription was expired in 67%. Only 12% of the patients with a systemic reaction acquired an allergy and immunology consultation.

“It is important to educate physicians to prescribe self-injectable epinephrine and refer to an allergist when a systemic reaction to venom allergy is identified,” the researchers wrote. – by Alaina Tedesco

Reference: Patel PJ, et al. Abstract 154. Presented at: American Academy of Allergy, Asthma & Immunology Annual Meeting; March 4-7, 2016; Los Angeles.

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