Allergen vial mixing and immunotherapy: Risks of infections and vial contamination

Objective: To study the risks of vial contamination and infection associated with immunotherapy vial mixing and injection. Study Design: Retrospective review of patient immunotherapy records from January 2000-June 2006. Setting: Tertiary care outpatient otolaryngology clinic. Results: Two hundred seventy-two patients were given 26,795 injections (average of 98.5 injections per patient). Three hundred ninety-nine total local reactions were reported by the subjects (1.49%; 95% CI 1.34%-1.63%). The majority (82%) of the local reactions occurred during escalation dosing. There were 23 episodes of wheezing or shortness of breath after injections (9.6 of 10,000). No patients experienced anaphylaxis. There was no documented skin or systemic infections as a result of the allergy injections. None of the patients experienced fever, discharge from the injection site, cellulitis, or required antibiotics. Conclusion: This review of immunotherapy records revealed no complications of infection from the preparation and administration of immunotherapy performed in an outpatient clinic.