Factors Associated With Epinephrine Use in the Treatment of Anaphylaxis in Infants and Toddlers.
J Allergy Clin Immunol Pract
; 12(2): 364-371.e1, 2024 02.
Article
em En
| MEDLINE
| ID: mdl-37923127
ABSTRACT
BACKGROUND:
Undertreatment of anaphylaxis with epinephrine continues to be an unmet need and is a particular challenge among infants and toddlers.OBJECTIVE:
To address this gap by identifying barriers and solutions to appropriate and timely administration of epinephrine.METHODS:
We conducted a national online survey among primary caregivers of children who experienced a severe food-induced allergic reaction when younger than 36 months. Outcomes of interest included epinephrine use in community and health care settings to treat probable anaphylaxis.RESULTS:
Of 264 probable anaphylaxis cases, 39% of infants (aged <12 months) and 61% of toddlers (aged 12-35 months) received epinephrine at any time during the child's most severe allergic reaction (P = .001). A previous diagnosis of a food allergy was reported in 62% of cases where epinephrine was used compared with 26% of cases where epinephrine was not used (P < .001). In children with a previous diagnosis of a food allergy, epinephrine was used in 89% of those who were prescribed an anaphylaxis action plan compared with 50% of those without a plan (P = .001). The adjusted odds ratio for the association between having an anaphylaxis action plan and epinephrine use in cases of probable anaphylaxis was 5.39 (95% confidence interval, 2.18-13.30).CONCLUSIONS:
Epinephrine use at any time (including in health care settings) during probable anaphylaxis is more likely in infants and toddlers with a previously diagnosed food allergy than those without diagnosis. The provision of an anaphylaxis action plan is also associated with increased epinephrine use during probable anaphylaxis in this population.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hipersensibilidade Alimentar
/
Anafilaxia
Limite:
Child, preschool
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Humans
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Infant
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article