title: Survey on practice of venom immunotherapy in France.
abstract: BACKGROUND
  Venom immunotherapy (VIT) is the only efficient prevention for sting-induced anaphylaxis, but its application is not without risks and needs precautions and standardization. European guidelines were proposed in 2005, but recent practice surveys and more recent knowledge raise the need for an update. The aim of this study was to analyze VIT practices in France, based on previous surveys in Europe but also extended to outcome event management.
  
  
  METHODS
  A paper questionnaire was sent widely to persons involved in venom treatment.
  
  
  RESULTS
  Eighty-six responses could be included from physicians actively involved in VIT induction evenly distributed in France. The survey shows that VIT was engaged from grade III down to grade I reactions, starting preferentially with the ultra-rush protocol. Premedication was used by 42% only and risks induced by co-treatment with β-blockers were well known but not with angiotensin-converting enzyme inhibitors. However, side effects were very variably managed from arrest to enhancement in doses, time-delay or duration. Similarly, we observed a large discrepancy in treatment evaluation (skin tests, biology, timing and interpretation), decision making for treatment termination (when and how long to be prolonged) and post-treatment follow-up (adrenaline kit, event record) as well as procedures in case of late relapse (new induction, different doses).
  
  
  CONCLUSIONS
  Our study shows that most recommendations were fully or partially followed and may need reminding, but many points need to be completed or updated with new tools and knowledge acquired during the last 10 years.
authors.affiliation: Allergology Unit, University Hospital, Saint-Etienne, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Dzviga
authors.affiliation: Immunology Lab, University Hospital, Saint-Etienne, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Matevi
authors.affiliation: Respiratory Diseases Unit, University Hospital, Dijon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bonniaud
authors.affiliation: Respiratory Unit, University Hospital, Reims, France.
authors.forename: François
authors.initials: F
authors.lastname: Lavaud
authors.affiliation: Allergology Unit, St. Luc Hospital, Lyon, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Girodet
authors.affiliation: Allergology Unit, APHM University Hospital, Marseille, France.
authors.forename: Joelle
authors.initials: J
authors.lastname: Birnbaum
authors.affiliation: Immunology Laboratory, University Hospital, Saint-Etienne, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Lambert
keywords: immunotherapy; practice survey; venom allergy