Steroids Don’t Seem to Help After Mild Anaphylaxis in Kids
Routine corticosteroid use after an emergency department (ED) visit for mild to moderate pediatric anaphylaxis doesn’t seem to offer any real benefit in preventing kids from having to return to teh hospital within 7 days, according to new research published in medicine.1
The study found that 4.4% of children who received dexamethasone had to revisit a healthcare facility, compared to 6.7% of those who received a placebo. This means there was only a small reduction in risk – 2.3% (95% CI, -5.8 to 8.3%) – and you’d need to treat about 44 children (95% CI, 12 to ∞) to prevent one extra return visit (P =.70).1
Corticosteroids are often used along with epinephrine and antihistamines when treating anaphylaxis, especially for patients in the hospital. Some studies have suggested they might shorten hospital stays for severe cases, but there hasn’t been much evidence to support using them after a child is sent home from the ED. Current guidelines from US and European medical organizations say corticosteroids are an option for kids after an ED visit for anaphylaxis, but aren’t required.
A large study in 2015 looked at over 5000 children who were discharged from the ED after anaphylaxis and found that about two-thirds (66%) received corticosteroids.2 Within 3 days, 5% of both the children who got steroids and those who didn’t had to return to the ED, raising questions about whether steroids actually help prevent symptoms from coming back.2
“As far as we certainly know,this is the first randomized clinical trial to test whether steroids can reduce anaphylactic reactions in kids treated for mild to moderate anaphylaxis,” said study investigators Rafah Al Sayyed,MD,from Hamad Medical corporation,and Khalid Alansari,MD,FRCPC,FAAP,from Weill Cornell Medical College and Qatar University Medical College.1
the researchers conducted the trial at the Pediatric Emergency Center of Hamad General Hospital in Qatar between June 2018 and February 2024. Children were eligible to participate if they were…