Published Online: September 6, 2014
Anaphylaxis is a severe allergic reaction that can occur after exposure to foods or other allergens. Anaphylaxis can be life threatening, and epinephrine is the only medication shown to save lives. In recent years, the number of children with food allergies has risen and, in turn, episodes of anaphylaxis are also on the rise.
In an article recently published in The Journal of Allergy and Clinical Immunology: In Practice, Fleming and colleagues investigate the impact and potential benefits of early treatment with epinephrine for food-induced anaphylaxis.
The researchers reviewed records of patients who presented to a pediatric emergency department for anaphylaxis due to food over a six-year period. They divided patients into two groups based on the timing of their treatment with epinephrine. The first group of patients was treated with epinephrine before emergency department (ED) arrival and the second was treated with epinephrine for the first time in the ED.
Over the six-year period, there were 384 visits for food-induced anaphylaxis. The median patient age was 5.2 years and approximately half were male. About two out of three patients received epinephrine before they arrived to the ED, while the rest first received epinephrine in the ED. Patients given epinephrine before arrival to the ED required fewer treatments overall, including fewer antihistamines, steroids, and inhaled medications. Importantly, only 17% of patients treated with epinephrine before arriving to the ED were hospitalized compared to 43% who were treated first in the ED, a significant difference. Already owning an epinephrine auto-injector greatly increased the odds of epinephrine being given early.
This study supports the prompt use of epinephrine for patients suffering from food-induced anaphylaxis. The findings point toward the continued need to educate first responders, especially parents, in determining the severity of a reaction and appropriately treating the first signs of anaphylaxis. Owning an epinephrine auto-injector dramatically increased the likelihood of receiving early treatment, which means that access to epinephrine may be the most important factor in decreasing hospitalizations for patients who experience food-induced anaphylaxis.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.