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Appropriate prescription of epinephrine remains the best available treatment
  1. J ABAY
  1. Southampton General Hospital
  2. Tremona Road,Southampton SO16 6YD, UK
  3. juneabay@hotmail.com

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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. Fifty eight per cent of children followed for five years experienced adverse reactions from accidental peanut exposure.1 Peanut is the most common food allergen causing anaphylaxis and pervades, still often uncited, in food processing. Anaphylaxis related to foods most commonly occurs in patients who have had previous severe reactions. However, minor initial reaction does not exclude a subsequent severe reaction to peanut.2

Any person at risk of anaphylaxis deserves the best available protection. It is reasonable to always have two Epipens available both at home and at school. A second Epipen provides back up if a faulty technique is used or one syringe is damaged. Anaphylaxis may be biphasic, recurring in 3% of children admitted with anaphylaxis.3

As advocates of children, paediatricians are unlikely to hand out epinephrine …

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