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Safety and efficacy of ant rush immunotherapy in children
Wiparat Manuyakorn1, Suwat Benjaponpitak1, Wasu Kamchaisatian1
1Division of Pediatrics Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Insights
Rush immunotherapy (RIT) using ant venom in children is safe and effective for rapid protection against stings. This study found a low incidence of severe systemic reactions during RIT, making it a viable treatment option.
Area of Science:
- Allergy and Immunology
- Pediatric Medicine
- Toxicology
Background:
- Rush immunotherapy (RIT) offers early access to maintenance therapy.
- Limited research exists on the safety and efficacy of ant RIT in pediatric populations.
Purpose of the Study:
- To assess the safety and efficacy of an ant RIT protocol in children.
- To identify risk factors for systemic reactions (SRs) during pediatric ant RIT.
Main Methods:
- Retrospective review of children undergoing a 3-day ant RIT protocol.
- Monitoring safety using the World Allergy Organization Subcutaneous Immunology Systemic Reaction Grading System.
- Assessing efficacy via reactions to field ant re-sting.
Main Results:
- Six systemic reactions (SRs) occurred in 324 injections (1.85%), all Grade 1-2.
- No association found between SRs and age, gender, atopy, or IgE sensitization levels.
- Four patients (28.5%) experienced Grade 3 SRs upon re-sting, resolving with increased maintenance dose.
Conclusions:
- Ant RIT in children is safe with a low rate of severe systemic reactions.
- Ant RIT provides a valuable alternative for rapid protection against ant stings.
- Younger age may be a risk factor for systemic reactions during ant re-sting.
Background:
The Rush Immunotherapy (RIT) protocol is a valid alternative in order to reach the maintenance phase early. However, there are scarce studies in the literature that have evaluated the safety and the efficacy of an ant RIT process in children.
Objective:
To evaluate the safety and the efficacy of an ant RIT protocol and to identify the risk factors for systemic reactions (SRs) during an RIT procedure in children.
Method:
A retrospective review was conducted for those children who were receiving an ant RIT procedure. The 3-day RIT protocol consisted of hourly subcutaneous injections in order to achieve a 0.5 ml maintenance dose of a 1:100 weight/ volume (wt/vol) of the Solenopsis invicta whole body extract. The safety for an RIT procedure was monitored by using the World Allergy Organization Subcutaneous Immunology Systemic Reaction Grading System. The efficacy was assessed by the reactions after a field ant re-sting.
Result:
A total of 20 children who were receiving an ant RIT therapy were reviewed. The mean age was 9.5±3.07 years. There were 6 systemic reactions (SRs) from 324 injections during the RIT procedure (1.85%). All of the systemic reactions were Grade 1-2. There were no associations of SRs regarding age, gender, an atopic history, or the levels of immunoglobulin E (IgE) sensitization to the ants. Among the 14 patients who experienced a field ant re-sting, 4 (28.5%) patients developed Grade 3 SRs. These Grade 3 reactions were resolved after an increase of the maintenance dose to 0.5 ml of a 1:50 wt/vol. There was a significant difference in the mean age of those children who had ant re-sting systemic reactions and those who had no reactions (6.75±0.95 year vs. 10.8±3.29, p=0.036).
Conclusion:
Rush immunotherapy with ant in children is safe and it has a low occurrence of severe systemic reactions. It is an alternative treatment for those patients requiring a rapid protection.
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