management of wasp or bee sting allergy

Last reviewed 01/2018

Clinicians typically give an emergency kit to people with a venom allergy who are considered at risk of systemic reactions

• kit includes adrenaline (epinephrine; intramuscular injection) and can also include other emergency treatments such as a high-dose antihistamine (oral), a corticosteroid (inhaled), and/or a bronchodilator (inhaled). Preventive measures include advice on how to avoid bee and/or wasp stings
  
  
• in the UK, clinicians consider offering venom immunotherapy to people with a history of systemic allergic reactions to bee venom and/or wasp venom
  • venom immunotherapy aims to reduce the risk of future systemic reactions and the severity of a systemic reaction when one occurs
    • people considered for venom immunotherapy are usually those who have had severe systemic reactions, or those who have experienced moderate systemic reactions and have additional risk factors, such as a high baseline serum tryptase or a high risk of future stings, or whose quality of life is significantly affected by venom allergy

    • pharmalgen is recommended as an option for the treatment of IgE-mediated bee and wasp venom allergy in people who have had:

      • a severe systemic reaction to bee or wasp venom, or a moderate systemic reaction to bee or wasp venom and who have one or more of the following:
        • a raised baseline serum tryptase,
        • a high risk of future stings or anxiety about future stings

      • treatment with Pharmalgen should be initiated and monitored in a specialist centre experienced in venom immunotherapy

Reference:

• 1) NICE (February 2012). Pharmalgen for the treatment of bee and wasp venom allergy