Safety and Efficacy of Hymenoptera and Fire Ant Rush Immunotherapy in Children
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Wiparat Manuyakorn, MD, PhD, Suwat Benjaponpitak, MD, Wasu Kamchaisatian, MD, Cherapat Sasisakulporn, B.Sc., Wanlapa Teawsomboonkit, RN

This study was to evaluate the safety and efficacy of rush immunotherapy (RIT) with hymenoptera and fire ant and identify risk factors for systemic reactions (SRs) in children.

Methods: A 10 year retrospective review was conducted in children receiving hymenoptera and/or fire ant RIT. The 3-days RIT protocol consisted of hourly subcutaneous injections to achieve the maintenance dose 100µg of hymenoptera venom or 0.5 ml of 1: 100 wt/vol fire ant. Safety of RIT was assessed using Subcutaneous Immunotherapy Systemic Reaction Grading System. Efficacy was assessed by the reaction after exposure.


Fifty children were reviewed: 22 with fire ant, 17 with honey bee, 20 with mixed vespid, 2 with paper wasp RIT. Eleven children received 2 different allergens RIT. The mean age was 10.06+ 2.78 years. 92% of studied children were male. 32 systemic reactions (3.93%) were occurred in 814 RIT shots: 10(1.2%) grade I SRs, 18(2.2%) grade II SRs and 4(0.49%) grade III SRs. There was no association of SRs with age, gender, atopic history, the level of IgE sensitization and type of insect. Among 23 patients experienced accidental exposure, 6 patients had no reaction, 1 patient developed grade II reaction and 3 children with fire ant RIT experienced grade III systemic reaction. However, these gr III reactions were resolved after increased the maintenance dose to 0.5 ml of 1:50 wt/vol fire ant.


Rush immunotherapy with hymenoptera and fire ant in children is safe and has low severe systemic reaction. It is an alternative treatment for patients requiring rapid protection.