{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T20:42:54Z","timestamp":1770669774587,"version":"3.49.0"},"reference-count":47,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2008,8,24]],"date-time":"2008-08-24T00:00:00Z","timestamp":1219536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2008,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold>Background\n\t\t\t\t\t<\/jats:bold> Venom immunotherapy (VIT) is the only effective treatment for prevention of serious allergic reactions to bee and wasp stings in sensitized individuals. However, controversies exist relating to diagnosis, indications for treatment and treatment schedules. We audited current practice of VIT in the United Kingdom to evaluate adherence to international guidelines.<\/jats:p><jats:p><jats:bold>Methods\n\t\t\t\t\t<\/jats:bold> An online questionnaire was sent to all clinicians practising immunotherapy identified on the British Society of Allergy and Clinical Immunology website. Eighty\u2010six questionnaires were sent and 53 responses (61.6%) were received. Of these, 48 (85%) carried out VIT at their centre.<\/jats:p><jats:p><jats:bold>Results\n\t\t\t\t\t<\/jats:bold> Skin prick tests (SPT) and serum venom\u2010specific IgE (SSIgE) were equally preferred as first\u2010line investigation. Fifty percent of the respondents perform intradermal tests if both SPT and SSIgE are negative. While 8% of respondents commence VIT in patients with negative SSIgE and a history of severe reaction, 57% prefer to repeat the tests in 6\u201312 months if serum tryptase is elevated. If the insect responsible is uncertain and SSIgE is detected against bee and wasp venoms, 22% of the respondents will desensitize to both while 32% initiate treatment against the venom with the higher SSIgE. A protocol of weekly up\u2010dosing for 12 weeks is preferred for induction and only 25% of respondents have ever used rush or ultra\u2010rush protocols. Three years is thought to be optimum duration of VIT by most (56%). Eleven percent perform sting challenges at the end of treatment. Although 47% measure SSIgE at the end of treatment, only 3% use these results as a basis for discontinuing VIT.<\/jats:p><jats:p><jats:bold>Conclusion\n\t\t\t\t\t<\/jats:bold> Currently there is considerable variation in the diagnosis and management of hymenoptera venom allergy in the United Kingdom. This audit has demonstrated that the current international guidelines for the diagnosis and management of hymenoptera venom allergy are not being followed by UK allergy practitioners.<\/jats:p>","DOI":"10.1111\/j.1365-2222.2008.03044.x","type":"journal-article","created":{"date-parts":[[2008,8,25]],"date-time":"2008-08-25T04:12:32Z","timestamp":1219637552000},"page":"1651-1658","source":"Crossref","is-referenced-by-count":17,"title":["Practice of venom immunotherapy in the United Kingdom: a national audit and review of literature"],"prefix":"10.1111","volume":"38","author":[{"given":"L.","family":"Diwakar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Noorani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. P.","family":"Huissoon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. J.","family":"Frew","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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Allergy \u2013 an unmet need.Royal College of Physicians Working Party: working party on the provision of allergy services in the UK June 2003."},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2005.00963.x"},{"key":"e_1_2_7_9_2","first-page":"1459","article-title":"Prevention and treatment of hymenoptera venom allergy","volume":"60","author":"Bonifazi F","year":"2005","journal-title":"guidelines for clinical practice"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.3109\/02770906609106941"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(97)70222-7"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-85-1-56"},{"key":"e_1_2_7_13_2","first-page":"781","article-title":"Insect sting allergy","volume":"107","author":"Reisman RE.","year":"2001","journal-title":"the dilemma of the negative skin test reactor"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2001.114706"},{"key":"e_1_2_7_15_2","first-page":"606","article-title":"Long\u2010term protection after stopping venom immunotherapy","volume":"101","author":"Lerch E","year":"1998","journal-title":"results of re-stings in 200 patients"},{"key":"e_1_2_7_16_2","first-page":"357","article-title":"Hymenoptera venom allergy","volume":"17","author":"Ebo DG","year":"2007","journal-title":"taking the sting out of difficult cases"},{"key":"e_1_2_7_17_2","first-page":"1110","article-title":"The CD63 basophil activation test in Hymenoptera venom allergy","volume":"59","author":"Sturm GJ","year":"2004","journal-title":"a prospective study"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.2000.00863.x"},{"key":"e_1_2_7_19_2","first-page":"268","article-title":"Double sensitization to honeybee and wasp venom","volume":"123","author":"Straumann F","year":"2000","journal-title":"immunotherapy with one or with both venoms? 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