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Epinephrine underutilized for anaphylaxis in Latin America

Nonsteroidal anti-inflammatory drugs and antibiotics were the primary drugs involved in hypersensitivity reactions in Latin American countries, according to data from a recent study. However, less than 25% of patients with anaphylaxis received epinephrine.

From December 2011 to November 2013, researchers administered the European Network of Drug Allergy questionnaire to 22 allergy units in Argentina, Brazil, Chile, Cuba, Colombia, Dominican Republic, Ecuador, Mexico, Paraguay, Uruguay and Venezuela. Their aim was to examine how hypersensitivity drug reactions (HDRs) are characterized and managed in Latin America.

There were 868 HDRs in 862 patients (mean age: 36.6 years; 67.2% female; 20.6% children and teenagers). Compared with adults and elderly patients, reactions were less severe among children (P<.0001). HDRs presented most frequently as urticaria and/or angioedema (71%), with anaphylaxis present in 27.3% of all cases; no deaths were reported.

Drugs most frequently prescribed were nonsteroidal anti-inflammatory drugs (52.3%), beta-lactam antibiotics (13.8%) and other antibiotics (10.1%). Diagnostic procedures most commonly used were skin prick tests (16.7%) and provocation tests (34.2%). Sixty-two percent of patients received treatment in the ED, which included antihistamines (68%) and/or corticosteroids (53%).  Less than 25% of patients presenting with anaphylaxis received epinephrine (22.8%) of patients who presented with anaphylaxis.

“This study describes the main features of HDRs in Latin America by providing a description of the studies and treatment performed using a validated and standardized questionnaire,” the researchers concluded. “The results of this study indicate the need to improve dissemination and implementation of guidelines and education of the general population about the public health issue of HDRs and the dangers of self-medication.”

Disclosure: The researchers report no relevant financial disclosures.