Does early epinephrine prevent food allergy admissions in young children?

Published online: April 14, 2020

Food allergy affects 8% of American children and is the leading cause of life-threatening allergic reactions. Few studies have been published looking at whether infants with food allergy reactions present to the emergency department differently than toddlers and preschoolers. Also, the effects of early emergency treatments for food allergy reactions in young children have not been studied.

In The Journal of Allergy and Clinical Immunology: In Practice, Jimmy Ko and colleagues published a study analyzing records of a large, integrated health care system (Kaiser Permanente Northern California) to see how children under age 5 years presented to the emergency department after food allergy reactions. Infants under age 12 months were compared to toddlers age 12 to under 24 months and preschoolers age 2 to under 5 years. Treatments given before and after arrival to the emergency department were studied to see if hospitalization rates were different in those receiving early treatment.

Infants who went to the emergency department with food allergy reactions had breathing symptoms (wheezing, difficulty breathing, cough) less often than toddlers and preschoolers. Egg was the most common food trigger for infants going to the emergency department, whereas peanut was the most common food trigger for toddlers and preschoolers. Children under age 5 who received epinephrine injections prior to hospital arrival were less likely to receive epinephrine in the emergency department but were admitted to the hospital for additional observation at a higher rate than children who did not receive early epinephrine. Overall, epinephrine treatment was underutilized in the emergency department.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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