Table 2

Common misconceptions in anaphylaxis and what current evidence reveals

Common ‘myths’What evidence tells us
Myth 1: Anaphylaxis often results in deathAnaphylaxis 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 anaphylaxisCutaneous 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 anaphylaxisIn around 20% of cases, no trigger is identified; this is known as idiopathic anaphylaxis
Myth 4: Epinephrine is dangerousEpinephrine 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 worsenEpinephrine, not antihistamines, is the first-line treatment for anaphylaxis
Myth 6: Corticosteroids prevent delayed or biphasic reactions in anaphylaxisThere 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 autoinjectorIt 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 anaphylaxisAutoinjectors are underused to treat anaphylaxis in the community
Myth 9: Prescription of an epinephrine autoinjector in isolation is life-savingOptimal 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 eggBoth vaccines are safe to administer in egg-allergic children, including those with previous anaphylaxis