Desensitization of patients with bee venom allergy--current status.

Bee venom allergy is a common problem in South Africa, and although most patients develop only local reactions after a sting, generalized life-threatening reactions may occur. Immunotherapy with purified bee venom has proved effective in preventing subsequent sting anaphylaxis. However, because of side-effects during a course of desensitization, the high cost of this form of therapy and the extended period for which therapy may be required, careful patient selection is essential. Only patients with documented generalized reactions should be considered for therapy. Patients with severe local reactions, and those with urticaria or other cutaneous symptoms, should not undergo desensitization. Although it is not yet known for how long desensitization should continue, a negative skin test 3-6 years after the initiation of therapy suggests that desensitization can be discontinued.