Allergen immunotherapy extract treatment set preparation: Making a safer and higher quality product for patients

Michael R. Nelson*, Maureen M. Petersen, Wayne O. Wolverton, Cecilia P. Mikita

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


The best possible allergen immunotherapy clinical outcomes require the provision of high quality and safe allergen immunotherapy extract preparations. Evolving national guidelines and regulatory bodies have devoted special attention to the safe compounding of sterile products, including allergen extracts. It is incumbent upon allergists preparing extract treatment sets for patients to be familiar with and adopt training, procedures and safety measures that lead to standardized high quality products. Preparers and supervisors must maintain ongoing competency in aseptic technique and prescribing principles, such as probable effective dose ranges, allergen cross-reactivity, and separation of high protease-containing extracts from susceptible extracts. Accordingly, knowledge and application of vial labeling, diluent selection, standard operating procedures, mixing log documentation, and mixing condition principles are a necessity. Although there have been no instances of infectious complications from allergen immunotherapy in a century of clinical practice, continued vigilance in the use of measures that ensure extract sterility is paramount. A review of allergen immunotherapy preparation recommendations and best practices based on published national guidelines is presented. Further study of preparation measures and prescribing principles will continue to advance the practice of allergen immunotherapy and offer opportunities for refinement of current recommendations.

Original languageEnglish
Pages (from-to)399-405
Number of pages7
JournalCurrent Allergy and Asthma Reports
Issue number4
StatePublished - Aug 2013
Externally publishedYes


  • Allergen immunotherapy
  • Compounded sterile product
  • Diluent
  • Extract
  • Practice parameter
  • Preparation
  • Safety
  • USP 797


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