Are Antihistamines and Steroids Helpful for Anaphylaxis?

Epinephrine is the standard first-line treatment for patients with anaphylaxis, but its use is often replaced or delayed by administration of antihistamines and corticosteroids. Researchers evaluated the efficacy of alternate interventions for anaphylaxis using a cohort of 3498 patients who were seen in emergency departments (EDs) and were included in a Canadian anaphylaxis registry.

Most cases were associated with food allergy in children. Fewer than one third of patients received epinephrine in the prehospital setting, and fewer than one half received it in the ED. Prehospital administration of epinephrine was associated with a fivefold lower need for ≥2 doses of epinephrine in the ED. Prehospital use of antihistamines further lowered the …