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Controversy
Adrenaline syringes are vastly over prescribed
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  • Published on:
    Prescribing epinephrine alone is not the complete answer to managing food allergy
    • Pamela W Ewan, Consultant Allergist
    • Other Contributors:
      • Andrew T Clark

    Dear Editor

    Unsworth believes epinephrine autoinjectors are vastly overprescribed [1] and addresses an important issue. Most of the reasons he gives and the papers he quotes consider provision of epinephrine autoinjector in isolation and fail to recognise that children with food allergy need a complete management package. For example, he uses evidence that patients fail to carry syringes, have out of date syringe...

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    Conflict of Interest:
    None declared.
  • Published on:
    The author responds
    Dear Editor,

    I was pleased to see that my article [1] provoked lively discussion [2,3,4] of this important issue. I am not surprised that others are also concerned about poor compliance. I agree with Wolffand Rumney [2] that adrenaline should never be the sole prescription. In addition to anti-histamines, prednisolone has a place. The idea of a written management plan also seems sensible.

    Hourihane [3] contrasted pre...

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    Conflict of Interest:
    None declared.
  • Published on:
    Appropriate prescription of epinephrine remains the best available treatment.
    Dear Editor,

    Epinephrine kits enable a food allergic child at risk of anaphylaxis to lead a normal life and participate in childhood activities that could easily be denied by a parent terrified of another allergen exposure.

    Avoidance of allergens rather than rescue epinephrine therapy is the basis of current management of food allergy. However, unexpected exposures are inevitable. 58% of children followed for...

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    Conflict of Interest:
    None declared.
  • Published on:
    Controversies in paediatrics?
    Dear Editor

    I was very disappointed to see that the first contribution to the series 'Controversy' was not written by a paediatrician. There are plenty of controversial topics in paediatrics, including the one cited. There are also plenty of paediatricians perfectly qualified to take part in informed debate about them, again including the topic cited. The absence of a contrasting viewpoint in the same issue suggested to me...

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    Conflict of Interest:
    None declared.
  • Published on:
    Adrenaline syringes: community perspective

    Dear Editor,

    We read with interest the paper by Unsworth [1] regarding the over prescribing of adrenaline syringes. We are sure we are not the only community paediatric team who have similar concerns, although perhaps from a different perspective. Dr Unsworth writes of the safety issues. We have more experience of the practical problems.

    Thanks to the availability of prompt training for school staff by comm...

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    Conflict of Interest:
    None declared.