Evidence update for the treatment of anaphylaxis

Amy Dodd, Nicholas Sargant, Andrew F Whyte, Jasmeet Soar

Research output: Contribution to journalReview article (Academic Journal)peer-review

4 Citations (Scopus)
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The Resuscitation Council UK has updated its Guideline for healthcare providers on the Emergency treatment of anaphylaxis. As part of this process, an evidence review was undertaken by the Guideline Working Group, using an internationally-accepted approach for adoption, adaptation, and de novo guideline development based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence to decision (EtD) framework, referred to as GRADE-ADOLOPMENT. A number of significant changes have been made, which will be reflected in the updated Guideline. These include: emphasis on repeating intramuscular adrenaline doses after 5 min if symptoms of anaphylaxis do not resolve; corticosteroids (e.g. hydrocortisone) no longer being routinely recommended for the emergency treatment of anaphylaxis; interventions for reactions which are refractory to initial treatment with adrenaline; a recommendation against the use of antihistamines for the acute management of anaphylaxis; and guidance relating to the duration of observation following anaphylaxis, and timing of discharge.

Original languageEnglish
Pages (from-to)86-96
Number of pages11
Early online date23 Apr 2021
Publication statusPublished - Jun 2021

Bibliographical note

Funding Information:
We are grateful to the following individuals for providing internal review to the updated RCUK Anaphylaxis Guideline and the updated recommendations. Sophie Farooque, Adam Fox, Graham Roberts, Hazel Gowland (patient advocate); on behalf of Resuscitation Council UK: Charles Deakin, Joe Fawke, David Gabbott, Matt Griffiths, Andrew Lockey, Ian Maconochie, Jerry Nolan, Gavin Perkins, Sophie Skellett.

Funding Information:
J. Soar is joint-chair of the Anaphylaxis Working group of the UK Resuscitation Council, Editor of Resuscitation and receives payment from the publisher Elsevier. P.J. Turner is supported by a UK Medical Research Council Clinician Scientist award (reference MR/K010468/1) and reports grants from UK Medical Research Council, NIHR/Imperial Biomedical Research Centre, UK Food Standards Agency, End Allergies Together, and Jon Moulton Charity Trust; personal fees and nonfinancial support from Aimmune Therapeutics, DBV Technologies, and Allergenis; personal fees and other fees from ILSI Europe and UK Food Standards Agency, outside the submitted work; and is current Chairperson of the WAO Anaphylaxis Committee, Chairperson of the Paediatric Allergy Group of the British Society for Allergy and Clinical Immunology, and joint-chair of the Anaphylaxis Working group of the UK Resuscitation Council. A.F. Whyte is current Chairperson of the Adult Allergy Group of the British Society for Allergy and Clinical Immunology. The rest of the authors declare that they have no relevant conflicts of interest.

Publisher Copyright:
© 2021 The Author(s)


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