Epinephrine auto-injectors prescribed most often for children with nut allergies

LOS ANGELES — Children with peanut or tree nut allergies had a significantly higher likelihood of receiving epinephrine auto-injector prescriptions from pediatricians, according to data presented at the 2016 American Academy of Allergy, Asthma & Immunology annual meeting.

“The NIAID-sponsored 2010 guidelines recommend that epinephrine auto-injector should be prescribed to all patients with a food allergy and an IgE-mediated reaction, but studies show that epinephrine is underprescribed,” Tamar B. Weinberger, MD, of the department of pediatrics at the Icahn School of Medicine at Mount Sinai, told Infectious Diseases in Children. “We assessed whether specific factors are associated with general practitioners’ prescription of epinephrine auto-injectors to children with food allergies.”

The researchers reviewed medical records of patients with a diagnosed food allergy from a single pediatric practice for a 1-year period. To determine the characteristics associated with epinephrine prescription, charts were reviewed for type of food allergy, prior systemic reaction or anaphylaxis, coexisting asthma, atopic dermatitis, environmental allergies and allergy-related ED visits.

Study results showed that 76.3% of patients with a peanut or tree nut allergy received a prescription for an epinephrine auto-injector vs. 53.9% of children without a nut-related allergy (P < .001). Using multivariate analysis, children with a nut allergy were more likely to be prescribed an auto-injector (adjusted OR = 2.2; 95% CI, 1.29-3.75).

Results also showed that children with a history of anaphylaxis (78.6% vs. 58.4%; P = .001) or asthma (68.8% vs. 56.3%; P = .023) were more likely to receive epinephrine auto-injectors than children without those conditions.

Ari Zelig

“Our results showed that peanut and/or tree nut allergy or a history of anaphylaxis is associated with a significantly higher likelihood of receiving epinephrine auto-injector prescriptions from pediatricians,” Ari Zelig, MD, an attending physician for the Montefiore Health System at the Albert Einstein College of Medicine, New York, said. “Since pediatricians play a vital role in managing children with food allergies, further education must be provided to ensure that all children with food allergy are adequately prepared to treat any allergic reaction.” – by David Costill

Reference:
Weinberger T, et al. Abstract 164. Presented at: the American Academy of Allergy, Asthma & Immunology Annual Meeting; March 4-7, 2016; Los Angeles.

Disclosure: The researchers report no relevant financial disclosures.