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Suboptimal care of peanut allergic children in Germany concerning professional dietary advice and the supply of self-injectable epinephrine
© Trendelenburg et al; licensee BioMed Central Ltd. 2013
Published: 25 July 2013
Patients with peanut allergy are advised to strictly avoid peanuts in their diet and to carry an emergency kit including self-injectable epinephrine at all times.
The aim of the study was to determine to which extent peanut allergic children in Germany are provided with self-injectable epinephrine and if they had received professional dietary advice.
63 peanut allergic children (median: age 6 years; peanut-specific IgE 73,5kU/l) who participated in an oral immunotherapy (OIT)-study were enrolled. Data concerning age of diagnosis, provision with self-injectable epinephrine, professional advice and performance of a peanut-free diet as well as the characterization of accidental allergic reactions to peanut (grade of severity I-V) were collected at their baseline visit of the OIT-study.
At baseline visit, 17/63 children (27%) had not been provided with self-injectable epinephrine although the diagnosis of their peanut allergy was already made 4 years (median) ago. Five of these 17 children had at least one severe allergic reaction after accidental peanut consumption (grade IV) in their history. 27/63 children (43%) had not received self-injectable epinephrine at initial diagnosis but later in their life. In 13 of these 27 cases self-injectable epinephrine was prescribed only after at least one severe allergic reaction to peanut (grade IV). 19/63 children (30%) had received self-injectable epinephrine directly at initial diagnosis. A strict avoidance of peanut was performed by 51/63 families (82%). 12/63 families (18%) did not avoid products labelled with “may contain traces of peanuts”. Only 13/63 families (21%) had received dietary advice from a dietician.
Currently, peanut allergic children are not sufficiently provided with self-injectable epinephrine and do not receive enough professional dietary advice in Germany. Accidental allergic reactions are common. Therefore we recommend prescribing an emergency kit including self-injectable epinephrine directly at initial diagnosis. Furthermore families should receive an emergency training and a professional dietary advice.
Disclosure of interest
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.