An Update on the Management of Anaphylaxis

Abstract

To highlight the latest evidence supporting management recommendations in anaphylaxis and discuss the implications for further research in anaphylaxis management. The acute management of anaphylaxis is largely centered on resuscitation and administration of epinephrine. There is little evidence to support the use of antihistamines and corticosteroids in the acute management of anaphylaxis. Anaphylaxis is an acute, systemic, potentially life-threatening reaction caused by the release of mast cell and basophil mediators that could lead to distributive shock. Anaphylaxis is associated with increased healthcare utilization and costs. The definition of anaphylaxis is largely based on clinical criteria with no validated biomarker confirming the diagnosis. Long-term follow-up is recommended to identify triggers and co-factors of anaphylaxis. Further, this helps to establish a plan for trigger avoidance and emergency action plan to manage subsequent episodes. Given the significant morbidity and mortality associated with this diagnosis, high quality randomized controlled studies are lacking to support management decisions in anaphylaxis.