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Updated: May 12, 2026
Sublingual Immunotherapy as an Alternative to Induce Protection Against Acute Respiratory Infections
Published on: August 30, 2014
Adherence to imported fire ant subcutaneous immunotherapy
Shayne C Stokes1, James M Quinn, Joshua J Sacha
1Division of Allergy and Immunology, Department of Medicine, Wilford Hall Medical Center, San Antonio, TX 78236, USA. shayne.stokes@us.af.mil
Background:
Imported fire ant (IFA) subcutaneous immunotherapy (SCIT) is safe and effective. For optimal protection, SCIT is given monthly for 3 to 5 years. Successful outcomes require patient adherence.
Objective:
To evaluate SCIT adherence in IFA allergic patients in an endemic area.
Methods:
Patients with systemic reactions to an IFA sting, with detectable specific IgE, who received a recommendation to start IFA SCIT were included. Initial reaction severity and demographic data were collected. Patients were contacted at 1 year regarding interval reactions to stings, SCIT adherence, and reason for nonadherence. Adherence rates were analyzed for association with age, sex, and severity of initial reaction.
Results:
Seventy-six patients were enrolled, and 71% adhered to the recommendation to start IFA SCIT. Subgroup analysis did not find significant differences. At 1 year, 97% completed follow-up for analysis, and only 35% remained adherent. Subgroup analysis did not find significant differences. Inconvenience and fear were reported as reasons for not following the recommendation to start or continue with IFA SCIT.
Conclusion:
IFA SCIT is a life-saving therapy that is safe and effective. Despite this, only 71% followed the recommendation to start, and at 1 year only 35% remained adherent. Adherence was not statistically related to age, sex, or severity of initial reaction. Logistical constraints and fear were significant impediments.
