From the Guidelines
Oral prednisone is not recommended as the first-line treatment for anaphylaxis, and its use should be limited to secondary prevention of biphasic or prolonged reactions after epinephrine administration. Epinephrine (adrenaline) administered via an auto-injector or syringe is the essential first-line medication for anaphylaxis, with a standard adult dose of 0.3-0.5 mg injected intramuscularly into the mid-outer thigh, which can be repeated every 5-15 minutes if symptoms persist 1. The use of oral prednisone as a secondary treatment is based on its ability to reduce inflammation and suppress immune responses, but its slow onset of action makes it unsuitable as a primary intervention for anaphylaxis 1.
Some key points to consider when using oral prednisone for anaphylaxis include:
- The typical adult dose is 40-60 mg daily for 3-5 days, while children typically receive 1-2 mg/kg/day (maximum 60 mg) for the same duration 1
- Prednisone takes hours to become effective, making it unsuitable as the primary intervention for anaphylaxis, which requires immediate treatment 1
- Patients should always carry epinephrine auto-injectors if they have a history of anaphylaxis and should seek emergency medical care immediately after using epinephrine, even if symptoms improve 1
- The use of glucocorticoids, such as prednisone, has been associated with reduced length of hospital stay, but there is no clear evidence to support their use in preventing biphasic or prolonged reactions 1
It is essential to note that the certainty of evidence around supplemental therapies in anaphylaxis management is very low, and more research is needed to determine the effectiveness of oral prednisone and other treatments in preventing biphasic or prolonged reactions 1.
From the Research
Oral Prednisone Use for Anaphylaxis
- The use of oral prednisone in the management of anaphylaxis is not explicitly mentioned as a first-line treatment in the provided studies 2, 3, 4, 5, 6.
- According to the study by 2, corticosteroids, which include prednisone, are considered adjunct medications that can be used after epinephrine administration in the management of anaphylaxis.
- The study by 4 mentions that glucocorticoids, such as prednisone, should be used only as third-line treatment for anaphylaxis, and their administration should never delay adrenaline injection.
- There is no mention of oral prednisone as a preferred route of administration for corticosteroids in anaphylaxis management in the provided studies 2, 3, 4, 5, 6.
- The primary focus of anaphylaxis management is on the prompt administration of epinephrine, followed by supportive care and adjunct medications as needed 2, 3, 4, 5, 6.