From the Research
Corticosteroid Use in Pediatric Anaphylaxis
- The use of corticosteroids in pediatric anaphylaxis is a topic of debate, with some studies suggesting a beneficial effect and others indicating a lack of evidence to support their routine use 1, 2.
- A study published in 2023 found that patients who received prehospital corticosteroids were more likely to require intravenous fluids in the emergency department and be admitted to the hospital 1.
- Another study published in 2017 found that corticosteroids do not prevent biphasic anaphylaxis and may have detrimental adverse effects, leading the authors to not advocate for their routine use in anaphylaxis 2.
- However, a study published in 2015 found that glucocorticoid administration was inversely associated with prolonged length of stay and subsequent epinephrine use among hospitalized children with anaphylaxis 3.
Preferred Corticosteroid in Pediatric Anaphylaxis
- There is no clear consensus on the preferred corticosteroid in pediatric anaphylaxis, as the evidence is limited and conflicting 1, 2, 3.
- A study published in 1998 found that idiopathic anaphylaxis in children can be treated with corticosteroids, but this is a specific condition and may not be generalizable to all cases of anaphylaxis 4.
- The use of corticosteroids in pediatric anaphylaxis should be individualized and based on the specific clinical scenario, taking into account the potential benefits and risks 5, 3.
Key Findings
- Epinephrine is the first-line treatment for anaphylaxis, and its early use is associated with improved outcomes 1, 5.
- Antihistamines may have a beneficial effect in anaphylaxis, but the evidence is limited 1, 5.
- Corticosteroids may be useful in specific cases of anaphylaxis, such as idiopathic anaphylaxis, but their routine use is not supported by evidence 2, 4, 3.