Venom allergy treatment practices in Poland in comparison to guidelines: next edition of the national audit.

INTRODUCTION

Venom immunotherapy treatment (VIT) is the only causal treatment of hymenoptera venom anaphylaxis, which aims to provide long-lasting immunoprotection against severe reactions to subsequent stings.

AIM

To reassess the compliance of VIT procedures in the Polish allergy centres with the European guidelines.

MATERIAL AND METHODS

A structured questionnaire survey conducted in all 33 VIT-centres. The response rate was 94%.

RESULTS

The ultrarush initial protocol was the most common protocol (71%, = 22), usually lasting for 3.5 h (50%, = 7). The most frequent (36%, = 11) time interval from the initial to the first maintenance dose (MD) was 14 days, ranging from 7 to 35 days. All centres used an MD of 100 μg. The most frequent time interval between subsequent MDs was 4 weeks (58%, = 18). Five years' of VIT was declared by 71% ( = 22). Before the termination of treatment, more than half of the centres (58%, = 18) performed sIgE and almost half (42%, = 13) performed skin tests. To confirm VIT efficacy, few centres (26%, = 8) conducted the sting challenge. About half of centres provided the patients with an adrenalin auto-injector both at the time of initial diagnostics and at the end of treatment. More than half (55%, = 17) used antihistamines in all patients. Almost half (45%, = 14) declared to stop treatment with β-blockers and almost one fourth (23%, = 7) discontinued angiotensin-converting-enzyme inhibitors.

CONCLUSIONS

In the most important procedures, there is a very high compliance with the guidelines. In the areas where the guidelines are not precise, we observed a large spread of results.