Published 10 July 2009, doi:10.1136/bmj.b2489
Cite this as: BMJ 2009;339:b2489

Practice

Uncertainties Page

Should antihistamines be used to treat anaphylaxis?

¹ St Josefskrankenhaus, Freiburg, Germany , ² Vienna Medical University, Vienna

The first 150 words of the full text of this article appear below.

Anaphylaxis is a serious allergic reaction that is rapid in onset and potentially fatal.¹ Guidelines and experts agree that adrenaline (epinephrine) is the first line treatment for anaphylaxis.² Internationally, however, treatment guidelines differ widely,³and the widespread use of antihistamines in anaphylaxis, often as first line treatment instead of adrenaline, has led to concern.^{4 5}

No randomised controlled clinical trials or observational studies exist to inform us: a Cochrane review recently failed to identify any randomised controlled clinical trials evaluating antihistamines in acute anaphylaxis⁶; only one prospective trial was identified but was excluded as it lacked a control group and did not study patients with anaphylaxis.⁷ Our own PubMed search also did not identify any randomised controlled clinical trials or observational or cohort studies examining the appropriateness of antihistamines in anaphylaxis.

Unsurprisingly, a recent comparison of important international guidelines found conflicting advice about antihistamines,³ reflecting the uncertainty in international clinical . . . [Full text of this article]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Article

Primary outcome measures

Simon G A Brown
BMJ 2009 339: b3368. [Extract] [Full Text]

This article has been cited by other articles:

• Brown, S. G A (2009). Primary outcome measures. BMJ 339: b3368-b3368 [Full text]  

Rapid Responses:

Read all Rapid Responses

There is a trial of promethazine

Arun S. Nanivadekar
bmj.com, 12 Jul 2009 [Full text]

Re: Re: There is a trial of promethazine

Doerthe A Andreae, et al.
bmj.com, 16 Jul 2009 [Full text]

What primary outcome for an antihistamine trial

Simon G A Brown
bmj.com, 3 Aug 2009 [Full text]

Online poll

Find out more >>