What is the lowest maintenance dose you will use if a patient continues to have anaphylaxis when trying to achieve maintenance dosing?  

Probably 1:1 0.2 ml. Most of the lesser dose maintenance patients are ones I inherited and had to go way back in the shot record to see what the indication for reduction was whether systemic vs long-lasting LLR or something else like an intolerance. I have a hard time believing that patients will ac...

Another approach might be to give a lower dose, perhaps 1.5 ml of a 1:1 every 2 weeks, so that the monthly dose would be a minimum of 0.3 ml. George GottliebDecatur GA

Was the patient evaluated for mastocytosis? Why is he or she getting anaphylaxis to usual doses of AIT?