Denver, CO—Just because pharmacists are filling prescriptions for epinephrine doesn’t mean that children who suffer a severe allergic reaction are getting doses in a timely manner.

A new study published in the Annals of Allergy, Asthma and Immunology finds that most children presenting to the emergency department (ED) or urgent care center (UCC) with anaphylaxis hadn’t received a shot from their epinephrine auto injector.

For the study, National Jewish Hospital–led researchers reviewed 408 patient records for children seen in an ED or UCC. Most of the patients, 65%, had a history of anaphylaxis, and 47% had been prescribed epinephrine.

“We found kids who had a reaction at home were less likely to receive epinephrine than kids who had a reaction at school,” noted lead author Melissa Robinson, DO. “Treatment with epinephrine is often delayed or avoided by parents and caregivers. And sometimes antihistamines are used even though they are not an appropriate treatment.”

The report notes that the odds of receiving epinephrine before arrival at the ED or UCC were significantly lower with a two-organ system (OR, 0.50) or three-organ system (OR, 0.41) presentation compared with one-organ system involvement. The most common trigger was found to be food of some type.

Overall, about 50% of children with severe allergic reactions got epinephrine, according to the study, including those who had received it before ED arrival and those who were given a shot at the hospital.

While the researchers weren’t able to determine why more children weren’t treated with the life-saving drug, they did note that patients who received epinephrine prior to arrival were also more likely to be discharged to their home compared to those who didn’t.

“Allergists want parents, caregivers and emergency responders to know epinephrine should always be the first line of defense when treating anaphylaxis,” added co-author David Stukus, MD, of Nationwide Children’s Hospital in Cincinnati, OH. “Our study found that only two-thirds of those who had an epinephrine prescription had their auto injector available at the time of their allergic reaction.”

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