Immunotherapy: critical appraisal, effectiveness and cost/benefit ratio.

A critical appraisal of the literature shows that allergy skin testing is safe, economical and useful when correlated by a meticulous medical history and physical examination. Immunotherapy is beneficial in appropriately selected patients, if properly performed using licensed and preferably standardized allergenic extracts. This article reviews the labelling and standardization of those extracts, the guidelines in determining their degree of effectiveness, their current status and their different nature through inhalation, contact, injection or ingestion. It emphasizes the basic steps in dealing with potential allergic complaints, enumerating the specific indications for immunotherapy, in which conditions it gives results and the extent of these results. The cost/benefit ratio of immunotherapy and the future prospects for allergy skin testing and immunotherapy are discussed.