Current Practices in Prescribing Auto-Injectable Epinephrine during Immunotherapy amongst Otolaryngic Allergists

Purpose: Allergen immunotherapy (AIT) while usually safe, is not without risk. Both sublingual (SLIT) and subcutaneous (SCIT) have the potential for systemic reactions including anaphylaxis. Materials Methods: A short survey was distributed to fellows of American Academy Otolaryngic Allergy (AAOA) (n = 553) in July 2019 determine current prescribing practices. Results: total 103/553 surveys were completed, giving a response rate 18.6%. Prescribing patterns SCIT showed 79.6% prescribed auto-injectable epinephrine (AIE) all patients, 11.7% only high risk 1.9% did prescribe AIE at all. SLIT similar with 71.8% all, or letting patient choose, 6.8% anyone. Just under half physicians responded affirmatively written anaphylaxis plan patients on immunotherapy. 48.5% reported treating in-office due skin testing past year, 6% SLIT. Conclusions: majority otolaryngic allergists are still both With recent higher costs attributed as well drug shortages, some risk-stratifying patients. While has treatment related reactions, does occur SLIT, thus making it imperative counsel clear protocol forms AIT.