In the largest study to-date investigating emergency treatment of food-related anaphylaxis in children, researchers have found that many children with severe food-related allergic reactions need a second dose of adrenaline to combat a severe allergic reaction.

Results of the six-year review of emergency department data collected at Children's Hospital Boston, in collaboration with Massachusetts General Hospital, have prompted the researchers to suggest that patients carrying EpiPens should carry two doses instead of one. They also suggested that consideration should be given to cost-saving approaches such as having unassigned second doses available at schools and day care centres.

Of the 1200 children (average age of 6 years old) who were treated for food-related allergic reactions between 2001 and 2006, 12 percent suffered an anaphylactic reaction that required a second dose of adrenaline to stabilise.

According to the researchers, of greatest concern was the finding that half of the children with food-induced anaphylactic reactions were not treated with adrenaline either before getting to the hospital or while at the hospital. Fewer than half the children with food-related allergic reactions left the hospital with a prescription for self-injectable adrenaline (Epi-Pens) and only 22 percent were advised by the hospital practitioners to see an allergist at a later date.

Forty-four percent of the children treated in the hospital settings had known food allergies, yet had accidentally consumed the offending foods. The researchers believe additional study is warranted to evaluate the long-term outcomes of children who experience an episode of food-related anaphylaxis and methods to improve and standardize their care.

Reference: Rudders et al. 2010 Pediatrics. Vol 125 (4). Doi:10.1542/peds.2009-2832
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