Ten steps in the prevention and treatment of food allergy and anaphylaxis
DOI:
https://doi.org/10.13112/pc.1139Keywords:
Food Hypersensitivity; Anaphylaxis; Epinephrine; Delivery of Health Care; ParentsAbstract
Serious allergic reactions develop within minutes or several hours after exposure to an allergen. In children, the majority of serious allergic reactions are caused by food allergens. Anaphylaxis is a serious allergic reaction that occurs rapidly and can cause death. Intramuscularly applied adrenaline is the first-line therapy for the treatment of anaphylaxis. Adrenaline autoinjectors should be prescribed to all patients who have had an anaphylactic reaction or are at high risk of developing one. Adrenaline autoinjectors should be used by parents, teachers, or older children in all anaphylactic reactions, including those less severe. Parents, children, and teachers should be regularly educated on how to use adrenaline autoinjectors. Children with severe food allergies and their parents face a high risk of severe allergic reactions during everyday life. The collaboration of children, parents, teachers, primary care specialists and allergologists, as well as the healthcare system and food industry is important to minimize the burden of severe food allergy.
References
1. Muraro A, de Silva D, Podesta M, Anagnostou A, Cardona V, Halken S et al. GA2LEN ANACare Centres and EFA. 10 practical priorities to prevent and manage serious allergic reactions: GA2LEN ANACare and EFA Anaphylaxis Manifesto. Clin Transl Allergy 2024;14:e70009. doi: 10.1002/clt2.70009.
2. Dribin TE, Muraro A, Camargo CA Jr, Turner PJ, Wang J, Roberts G et al. GA(2)LEN Anaphylaxis Study Team. Anaphylaxis definition, overview, and clinical support tool: 2024 consensus report-a GA2LEN project. J Allergy Clin Immunol 2025;156:406-17.e6. doi: 10.1016/j.jaci.2025.01.021. Epub 2025
3. Grabenhenrich LB, Dölle S, Moneret-Vautrin A, et al. Anaphylaxis in children and adolescents: the European Anaphylaxis Registry. J Allergy Clin Immunol. 2016; 137:1128-37.e1. doi: 10.1016/j.jaci.2015.11.015
4. Höfer V, Dölle-Bierke S, Francuzik W. Fatal and near-fatal anaphylaxis: data from the European Anaphylaxis Registry and National Health Statistics. J Allergy Clin Immunol Pract. 2024; 12: 96-105.e8. doi: 10.1016/j.jaip.2023.09.044
5. Tejedor Alonso MA, Moro-Moro M, Múgica-García MV. Epidemiology of anaphylaxis: contributions from the last 10 years. J Investig Allergol Clin Immunol. 2015; 25:163-75.
6. Sicherer SH, Sampson HA. Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018;141:41-58. doi: 10.1016/j.jaci.2017.11.003.
7. Muraro A, de Silva D, Halken S, Worm M, Khaleva E, Arasi S et al. GA2LEN Food Allergy Guideline Group; GALEN Food Allergy Guideline Group. Managing food allergy: GA2LEN guideline 2022. World Allergy Organ J 2022;7;15:100687. doi: 10.1016/j.waojou.2022.100687.
8. Dribin TE, Waserman S, Turner PJ. Who Needs Epinephrine? Anaphylaxis, Autoinjectors, and Parachutes. J Allergy Clin Immunol Pract 2023;11:1036-46. doi: 10.1016/j.jaip.2023.02.002.
9. Muraro A, Worm M, Alviani C, Cardona V, DunnGalvin A, Garvey LH et al. European Academy of Allergy and Clinical Immunology, Food Allergy, Anaphylaxis Guidelines Group. EAACI guidelines: Anaphylaxis (2021 update). Allergy. 2022;77:357-77. doi: 10.1111/all.15032.
10. Ewan PW, Clark AT. Efficacy of a management plan based on severity assessment in longitudinal and case–controlled studies of 747 children with nut allergy: proposal for good practice. Clin Exp Allergy 2005;35:751–6.
11. Muraro A, Clark A, Beyer K, Borrego LM, Borres M, Lødrup Carlsen KC et al. The management of the allergic child at school: EAACI/GA2LEN Task Force on the allergic child at school. Allergy 2010;65:681-9. doi: 10.1111/j.1398-9995.2010.02343.x.
12. Noimark L, Wales J, Du Toit G, Pastacaldi C, Haddad D, Gardner J, et al. The use of adrenaline autoinjectors by children and teenagers. Clin Exp Allergy 2012;42:284–92.
13. Patel N, Chong KW, Yip AYG, Ierodiakonou D, Bartra J, Boyle RJ, et al. Use of multiple epinephrine doses in anaphylaxis: a systematic review and meta-analysis. J Allergy Clin Immunol 2021;148:1307–15
14. Ebisawa M, Lowental R, Tanimoto S, Takahshy K, Yanagida N, Sato S. Neffy, epinephrine nasal spray, Demonstrates a Positive Efficacy and Safety Profile for the Treatment of Allergic Reactions in Pediatric Patients at-Risk of Anaphylaxis: Phase 3 Study Results. J Allergy Clin Immunol 2024; 153: Suppl AB371
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Iva Topalušić, Ozana Hofmann Jaeger, Maja Bosanac, Ivan Pavić

This work is licensed under a Creative Commons Attribution 4.0 International License.
By publishing in Paediatria Croatica, authors retain the copyright to their work and grant others the right to use, reproduce, and share their research articles in accordance with the Creative Commons Attribution License (CC BY 4.0), which allows others to distribute and build upon the work as long as they credit the author for the original creation.

