Mwandishi:
ULY CLINIC
Mhariri:
ULY CLINIC
Imeboreshwa:
20 Oktoba 2026, 15:06:27
Insect Bites and Stings (Bees, Wasps, Ants, Spiders, Centipedes) Management
Most serious sting reactions are caused by insects of the order Hymenoptera (bees, wasps and ants). Spiders, scorpions, centipedes and millipedes can also bite or sting.
Clinical presentation
Local pain, swelling, redness and itching at the site
Severe reactions: generalised urticaria, angioedema, wheezing, difficulty breathing, hypotension, anaphylaxis
Non-pharmacological management
Clean the area with soap and water.
Remove a stinger by scraping gently with a fingernail, card or gauze; do not use tweezers (they squeeze in more venom).
Apply a cold compress wrapped in cloth.
Avoid scratching.
Pharmacological management
Indication | Management |
Pain and inflammation | A: Ibuprofen (PO) adults 400–800 mg every 8 hours for 3 days; children 10 mg/kg every 8 hours (maximum 400 mg/day) for 3 days |
Moderate reaction or severe local swelling | A: Prednisolone (PO) 2 mg/kg/day once daily (maximum 80 mg/day) for 5 days |
Allergic symptoms (sedating antihistamine) | A: Chlorpheniramine (PO): under 6 years 1 mg every 4–6 hours (max 6 mg/day); 6–12 years 2 mg (max 12 mg/day); over 12 years and adults 4 mg (max 24 mg/day) |
Non-sedating antihistamine | C: Loratadine (PO): 2–5 years 5 mg once daily; 6 years and above 10 mg once daily |
Anaphylaxis | A: Epinephrine (IM) 0.5 mg (0.5 ml of 1:1000) in the anterolateral thigh in adults (children 0.01 mg/kg, maximum 0.5 mg), repeated every 5–15 minutes if needed, with full emergency care |
After centipede bites, make sure tetanus vaccination is up to date.