Allergy training and immunotherapy in Latin America: results of a regional overview Carlos E. Baena-Cagnani, MD * ; Désirée Larenas Linnemann, MD y ; Maximiliano Gómez, MD z ; Sandra González Díaz x ; Dirceu Solé k ; Mario Sánchez Borges, MD { ; Jean Bousquet, MD # ; Juan Carlos Sisul, MD ** ; Giorgio Walter Canonica, MD yy ; José Gereda, MD zz ; and Giovanni Passalacqua, MD yy ; on behalf of the SLAAI Immunotherapy Working Group * Research Center for Respiratory Medicine (CIMER), Catholic University, Fundación LIBRA, Córdoba, Argentina y Hospital Médica Sur, Mexico DF, Mexico z Hospital San Bernardo, Salta, Argentina x Centro Regional de Alergia, Universidad de Nuevo León, Monterrey, Mexico k Escola Paulista de Medicina, São Paulo, Brazil { Centro Médico-Docente La Trinidad, Caracas, Venezuela # University Hospital, Hôpital Arnaud de Villeneuve, Montpellier, France ** ARIA Paraguay/SLAAI, Asunción, Paraguay yy Allergy and Respiratory Diseases, Department of Internal Medicine, University of Genoa, Genoa, Italy zz Clnica Ricardo Palma, Lima, Perú A R T IC L E IN F O Article history: Received for publication May 21, 2013. Received in revised form August 13, 2013. Accepted for publication August 13, 2013. A B ST R AC T Background: One main practice gap in allergology that has been detected in several regions of the world is the application of specific immunotherapy (SIT). The prescription and practice of SIT should characterize allergologic specialists, but there are regional discrepancies in such practice. A detailed knowledge of the regulatory and legislation aspects and drawbacks would help improve and harmonize SIT practice. Objective: To describe in Latin America the level of allergy training and the characteristics of the use of SIT, including the medical and legal aspects. Methods: Three sources were used: a 24-item questionnaire sent to 22 allergologic leaders in 11 Latin American countries, 2 face-to-face meetings, and information from health authorities involved in the approval of medical substances. Results: In 56% of countries, the specialty of allergology is a third-level care specialty and/or a subspecialty. Two countries have a special training program for pediatric allergists. Passing a board examination is mandatory in 3 countries, and recertification every 2 to 5 years occurs without examination. Sublingual and subcutaneous SITs are available in all Latin American countries. No legislation restricts SIT prescription and it can be performed by nonspecialists in 7 of 11 countries. In 90% of countries, allergists use allergen extracts from the United States (subcutaneous immunotherapy) and Europe (sublingual and subcutaneous immu- notherapies), and 50% also manufacture extracts locally. Only 1 country has legal requirements for the quality of raw materials. SLAAI Immunotherapy Working Group: Oscar Aldrey (Caracas, Venezuela); Estrella Asayag (Buenos Aires, Argentina); Héctor A. Badellino (San Francisco, Argentina); Susana de Barayazarra (Córdoba, Argentina); Ricardo Cardona Villa (Medellín, Colombia); Antonio Castillo (Santo Domingo, Dominican Republic); Alfonso M. Cepeda (Barranquilla, Colombia); Iván Chérrez (Guayaquil, Ecuador); Linda Cox (Fort Lauderdale, Florida); Víctor H. Croce (Córdoba, Argentina); J. Sebastián Croce (Córdoba, Argentina); Mabel N. Cuello (Córdoba, Argentina); Alicia de Falco (La Plata, Argentina); Jaime Guggiari (Asunción, Paraguay); M. Antonieta Guzmán (Santiago, Chile); Rodolfo Haller (Barranquilla, Colombia); Juan C. Ivancevich (Buenos Aires, Argentina); Edgardo J. Jares (Buenos Aires, Argentina); Dennis Ledford (Tampa, Florida); M. Angélica Marinovich (Santiago, Chile); José Mori San Román (Lima, Peru); Ralph Mösges (Köln, Germany); Noel Rodríguez Pérez (Matamoros, Mexico); Giovanni A. Rossi (Genoa, Italy); Marcela Soria (La Plata, Argentina); João Tebyriçá (Rio de Janeiro, Brazil); Alvaro Teijeiro (Córdoba, Argentina); Marilyn Urrutia Pereira (Uruguaiana, Brazil); Marylin Valentín Rostán (Montevideo, Uruguay); Miguel A. Vinuesa (Rosario, Argentina); Anahí Yáñez (Buenos Aires, Argentina). Reprints: Giovanni Passalacqua, MD, Allergy and Respiratory Diseases, Department of Internal Medicine, IRCCS San Martino, IST, University of Genoa, L go R Benzi 10, 16132 Genoa, Italy; E-mail: passalacqua@unige.it. Disclosures: Dr Larenas Linnemann has received travel grants from UCB, MSD, Seno- siain Almirall, and Hillister Stier; has received speaker’s fees from MSD, Astra-Zeneca, and GlaxoSmithKline; has served on the advisory board of Almirall and Hillister Stier; has received financial support from Greer Laboratories and ALK Abelló; and has served as chair of immunotherapy committees for the American Academy of Allergy, Asthma, and Immunology and Colegio Mexicano de Inmunología Clínica y Alergia and as vice-chair for the American Academy of Allergy, Asthma, and Immunology. Contents lists available at ScienceDirect 1081-1206/13/$36.00 - see front matter Ó 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.anai.2013.08.011 Ann Allergy Asthma Immunol 111 (2013) 415e419