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Infection Control-Related Administrative Policies and Work Restrictions

Course Number: 473

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Treatment Strategies

Once an individual develops an allergy to latex, special precautions are needed to prevent exposure at home, at work, and during healthcare. Patients and OHCP should be aware of common natural rubber latex products, as well as foods with cross-reactive proteins.23 Pretreatment with antihistamines, corticosteroids, and bronchodilators is unpredictable in preventing IgE-mediated anaphylaxis and is not recommended. Complete avoidance is the most effective approach to dealing with latex allergy.39

Signs and symptoms of latex allergy resolve quickly with avoidance; however, elevated IgE levels can remain detectable for more than 5 years after exposure.40 This observation underscores the importance of a policy of latex avoidance. OHCP and patients with a history of immediate hypersensitivity reaction to latex proteins should carry epinephrine and wear a Medical Alert bracelet.14 Strategies for the management of emerging allergic reactions to latex are presented in Table 3.41-43

Table 3. Strategies for the Treatment of Allergic Reactions to Latex Products.41-43

Allergic contact dermatitis
  1. Stop exposure to latex
  2. Topical high-potency corticosteroid
    1. Fluocinonide (Lidex®, others), 0.05% ointment
Allergic rhinitis
  1. Stop exposure to latex
  2. Intranasal corticosteroid
    1. Fluticasone propionate (Flonase®, others), 1-2 sprays in each nostril
Acute urticaria
  1. Stop exposure to latex
  2. Oral H1-receptor antagonist
    1. Cetirizine (Zyrtec®, others), 5-10 mg, once per day
Acute asthma
  1. Stop exposure to latex
  2. Place patient in sitting position
  3. Provide immediate oxygen
    1. 2-4 L/min by nasal cannula
  4. Inhaled beta2-adrenergic agonist
    1. Albuterol (Proventil®, others), 2-4 puffs
  5. If wheezing persists, activate EMS
Anaphylaxis
  1. Stop exposure to latex
  2. Place patient in supine position and elevate legs
  3. Administer epinephrine
    1. Adults: epinephrine (Symjepi®, EpiPen®, others), 0.3 mg, IM (anterolateral thigh) – may be repeated in 20 minutes if necessary
    2. Child: epinephrine (Symjepi®, EpiPen Jr.®, others), 0.15 mg, IM (anterolateral thigh) – may be repeated in 20 minutes if necessary
  4. Activate EMS
  5. CPR, if indicated

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