Prescription of Epinephrine Autoinjectors to Children with Food Allergies in a General Pediatric Clinic
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Tamar Weinberger, Ari Zelig, MD, Allison Gault, MD, Julie Wang, MD FAAAAI
Rationale: Current guidelines recommend the prescription of epinephrine autoinjectors to all children with food allergies. We assessed whether specific factors are associated with general practitioners’ prescription of epinephrine autoinjectors to children with food allergies.

Methods: A retrospective chart review was performed of children with a diagnosis of food allergy over a one-year period from a general pediatrics practice. Charts were reviewed for prescription of epinephrine, type of food allergy, age, sex, prior systemic reaction or anaphylaxis, coexisting asthma, atopic dermatitis, environmental allergies, and emergency department visits for allergic reactions or asthma exacerbations. 

Results: Of the 317 charts analyzed, 139 had documented peanut and/or tree nut allergy. 76.3% of those with peanut and/or tree nut allergy received epinephrine prescriptions compared to 53.9% among those without (p<0.001). Patient’s with a history of anaphylaxis were also more likely to receive a prescription (78.6% versus 58.4%, p=0.001) as were asthmatic patients (68.8% versus 56.3%, p=0.023). After adjusting for confounding variables, children with peanut and/or tree nut allergy were 2.2 times more likely to receive prescriptions for epinephrine (OR=2.20 (95% CI 1.29-3.75, p=0.004)) and children with prior anaphylaxis were twice as likely to receive prescriptions (p=0.014).

Conclusions: Peanut and/or tree nut allergy and a history of anaphylaxis are associated with a significantly higher likelihood of receiving epinephrine autoinjector prescriptions from pediatricians.  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 reactions that may occur.