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Insect bites and stings - Management
How do I manage systemic reactions to an insect bite or sting?
- If a severe systemic reaction occurs, such as wheezing or other signs of respiratory distress, or hypotension:
- Treat urgently as for anaphylaxis and admit to hospital.
- If there are symptoms of systemic toxicity that suggest impending anaphylaxis (e.g. abdominal pain, vomiting, rhinitis and conjunctivitis, or a sense of impending doom):
- Treat as for anaphylaxis and admit to hospital.
- If generalized urticaria occurs, but the person is otherwise well:
- Give an oral antihistamine and an oral corticosteroid.
- Offer a non-sedating antihistamine to control daytime symptoms.
- Consider giving an additional sedating antihistamine at night if the itch is interfering with sleep.
- In adults, give prednisolone 40 mg once a day, and in children give 1–2 mg/kg body weight once a day.
- Continue prednisolone for 3–5 days, depending on the severity of the reaction.
- Advise the person to seek urgent medical help if the rash worsens, swelling develops which involves the mouth or throat, or wheeze or breathing difficulty occurs.
In depth
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