Common misconceptions in anaphylaxis and what current evidence reveals
| Common ‘myths’ | What evidence tells us |
| Myth 1: Anaphylaxis often results in death | Anaphylaxis can be life-threatening, but the majority of reactions do not result in severe outcomes |
| Myth 2: There are no hives so it can’t be anaphylaxis | Cutaneous symptoms (most commonly urticaria or ‘hives’) are absent in around 10% of anaphylaxis reactions |
| Myth 3: No trigger for the reaction is identified, therefore it is not anaphylaxis | In around 20% of cases, no trigger is identified; this is known as idiopathic anaphylaxis |
| Myth 4: Epinephrine is dangerous | Epinephrine given by intramuscular injection into the outer mid-thigh is very safe |
| Myth 5: Antihistamines can be used to treat anaphylaxis initially; epinephrine is only needed if symptoms worsen | Epinephrine, not antihistamines, is the first-line treatment for anaphylaxis |
| Myth 6: Corticosteroids prevent delayed or biphasic reactions in anaphylaxis | There is insufficient evidence to support the use of corticosteroids prevent delayed or biphasic reactions in anaphylaxis |
| Myth 7: Only children who have had anaphylaxis need an epinephrine autoinjector | It is very difficult—if not impossible—to accurately predict who is at risk of severe anaphylaxis |
| Myth 8: Epinephrine autoinjectors are overprescribed and overused in anaphylaxis | Autoinjectors are underused to treat anaphylaxis in the community |
| Myth 9: Prescription of an epinephrine autoinjector in isolation is life-saving | Optimal management of food allergic patients and treatment of anaphylaxis has many facets and is not limited to a prescription for an epinephrine autoinjector |
| Myth 10: MMR and influenza vaccination are contraindicated in patients with previous anaphylaxis to egg | Both vaccines are safe to administer in egg-allergic children, including those with previous anaphylaxis |