Epinephrine Treatment Lacking in Children with Peanut Allergies

San Francisco—In a study of people with allergist-confirmed peanut allergy, researchers found that healthcare facilities underprescribed epinephrine autoinjectors, and patients did not use epinephrine as often as guidelines recommended. The authors concluded that medical professionals should prescribe epinephrine to anyone who is susceptible to an allergic reaction to peanuts, and noted that prompt administration of epinephrine is the only effective treatment for anaphylaxis. The results were presented at the AAAAI meeting in a poster session titled The Use of Epinephrine for the Treatment of Initial Allergic Reactions to Peanut. Moshe Ben-Shoshan, MD, division of pediatric allergy and clinical immunology at McGill University’s Health Center in Montreal, Quebec, Canada, was the study’s lead author. The authors recruited 724 patients from Montreal Children’s Hospital and food allergy advocacy associations in Canada. Of the 724 who had an initial reaction to peanut, 629 were not diagnosed before the reaction. The median age of the patients’ first reaction was 1.6 years, and 46.1% of those people diagnosed with a peanut allergy were brought into a healthcare facility. Only 23.1% of patients who went to a healthcare facility received epinephrine, while 55.9% were administered medications other than epinephrine, and 21.0% did not receive treatment. Of the patients who received epinephrine, 58.0% were administered epinephrine autoinjectors. The authors said that patients with more severe allergic reactions were more likely to go to healthcare facilities, and the rates of epinephrine prescriptions increased based on the severity. For instance, of the people who went to healthcare facilities, 9.1% of patients who had a mild reaction to peanuts received epinephrine compared with 17.6% of patients with a moderate reaction and 40.7% of patients with a severe reaction. A covariate analysis found that the following factors were associated with epinephrine treatment in healthcare facilities: the severity of reaction (odds ratio [OR], 3.26; 95% confidence interval [CI], 1.72-6.15) and family history of atopy (OR, 2.25; 95% CI, 1.20-4.20). The following factors were associated with the prescription of epinephrine autoinjectors: the use of epinephrine for the first peanut allergy reaction (OR, 5.23; 95% CI, 2.39-11.45), living in Quebec (OR, 2.55; 95% CI, 1.43-4.56), and the reaction occurring in a more recent calendar year (OR, 1.09; 95% CI, 1.02-1.16), the study found. This study was supported by McGill University’s Health Center, Montreal Children’s Hospital, and AllerGen NCE, Inc.