{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:48:28Z","timestamp":1761061708494,"version":"build-2065373602"},"reference-count":20,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T00:00:00Z","timestamp":1662681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>In the era of evidence-based medicine, physicians worldwide should abide by universally approved practices and healthcare units should seek quality control and operational improvement. This audit evaluates the degree of compliance with the European Academy of Allergy and Clinical Immunology guidelines for the diagnosis and treatment of anaphylaxis in a pediatric Allergy Department. Medical records of 248 children with food-induced allergic reactions who presented both on emergency and outpatient basis were reviewed. Data were also collected from the e-prescription database and anaphylaxis severity was graded according to Sampson\u2019s criteria. An accuracy metric was used to calculate the consistency rate. Anaphylaxis was documented in 188\/423 allergic reactions. The degree of agreement for the classification of the reactions as anaphylactic was 88.3%, while the respective rate for non-anaphylactic was 58.7%. In the anaphylactic cases, adrenaline was prescribed in 84.8%, while the respective rates for other drugs were: antihistamines: 27.6%; corticosteroids: 26.1%; inhaled \u03b22-agonists: 11.8%. This study, through the example of pediatric food-induced anaphylaxis, underlines the significance of compliance to guidelines, organized documentation in healthcare units using specially formulated medical history forms and continuous medical stuff training. Thus, diagnosis and treatment practices can be improved for the benefit of patients.<\/jats:p>","DOI":"10.3390\/jpm12091477","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T01:44:03Z","timestamp":1663033443000},"page":"1477","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diagnosis, Management and Prescription Practices of Adrenaline in Children with Food-Induced Anaphylaxis: Audit in a Specialized Pediatric Allergy Department"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2141-6163","authenticated-orcid":false,"given":"Konstantinos","family":"Vamvakaris","sequence":"first","affiliation":[{"name":"Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Thivon & Levadeias St., Goudi, GR-11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alkmini","family":"Koumpoura","sequence":"additional","affiliation":[{"name":"Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Thivon & Levadeias St., Goudi, GR-11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2905-6417","authenticated-orcid":false,"given":"Maria","family":"Farmaki","sequence":"additional","affiliation":[{"name":"Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Thivon & Levadeias St., Goudi, GR-11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Lakoumentas","sequence":"additional","affiliation":[{"name":"Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Thivon & Levadeias St., Goudi, GR-11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6658-4828","authenticated-orcid":false,"given":"Maria","family":"Pasioti","sequence":"additional","affiliation":[{"name":"Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Thivon & Levadeias St., Goudi, GR-11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4448-3468","authenticated-orcid":false,"given":"Nikolaos","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Thivon & Levadeias St., Goudi, GR-11527 Athens, Greece"},{"name":"Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester M13 9PL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9204-1923","authenticated-orcid":false,"given":"Paraskevi","family":"Xepapadaki","sequence":"additional","affiliation":[{"name":"Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Thivon & Levadeias St., Goudi, GR-11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,9]]},"reference":[{"key":"ref_1","unstructured":"(2022, August 25). General Medical Council: Good Medical Practice (Last Updated on 29 April 2019). Available online: https:\/\/www.gmc-uk.org\/-\/media\/documents\/good-medical-practice---english-20200128_pdf-51527435.pdf."},{"key":"ref_2","unstructured":"National Institute for Health and Clinical Excellence (2022, August 25). Principles for Best Practice in Clinical Audit. Available online: http:\/\/www.nice.org.uk\/media\/796\/23\/BestPracticeClinicalAudit.pdf."},{"key":"ref_3","unstructured":"Copeland, G. (2022, August 25). A Practical Handbook for Clinical Audit. NHS Clinical Governance Support Group. Available online: https:\/\/citeseerx.ist.psu.edu\/viewdoc\/download?doi=10.1.1.464.7819&rep=rep1&type=pdf."},{"key":"ref_4","unstructured":"Hughes, M. (2022, August 25). A Manual for Lay Members of the Clinical Audit Team. Healthcare Quality Improvement Partnership. Available online: https:\/\/www.hqip.org.uk\/wp-content\/uploads\/2018\/02\/developing-clinical-audit-patient-panels.pdf."},{"key":"ref_5","unstructured":"Hexter, A.T. (2013). How to Conduct a Clinical Audit: A Guide for Medical Students, Manchester Royal Infirmary."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1111\/all.12437","article-title":"Anaphylaxis: Guidelines from the European Academy of Allergy and Clinical Immunology","volume":"69","author":"Muraro","year":"2014","journal-title":"Allergy"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e20164006","DOI":"10.1542\/peds.2016-4006","article-title":"Epinephrine for First-aid Management of Anaphylaxis","volume":"139","author":"Sicherer","year":"2017","journal-title":"Pediatrics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1016\/j.jaip.2019.12.015","article-title":"Epinephrine in the Management of Anaphylaxis","volume":"8","author":"Brown","year":"2020","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1542\/peds.111.S3.1601","article-title":"Anaphylaxis and emergency treatment","volume":"111","author":"Sampson","year":"2003","journal-title":"Pediatrics"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1111\/all.12429","article-title":"EAACI food allergy and anaphylaxis guidelines: Diagnosis and management of food allergy","volume":"69","author":"Muraro","year":"2014","journal-title":"Allergy"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1016\/j.pcl.2019.06.005","article-title":"Anaphylaxis in Children and Adolescents","volume":"66","author":"Poowuttikul","year":"2019","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Barni, S., Liccioli, G., Sarti, L., Giovannini, M., Novembre, E., and Mori, F. (2020). Immunoglobulin E (IgE)-Mediated Food Allergy in Children: Epidemiology, Pathogenesis, Diagnosis, Prevention, and Management. Medicina, 56, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/32143431\/.","DOI":"10.3390\/medicina56030111"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1159\/000371646","article-title":"Immunological basis of food allergy (IgE-mediated, non-IgE-mediated, and tolerance)","volume":"101","author":"Kim","year":"2015","journal-title":"Chem. Immunol. Allergy"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.jpeds.2020.05.045","article-title":"Poor asthma control remains a risk factor for severe anaphylaxis","volume":"224","author":"Grigoletto","year":"2020","journal-title":"J. Pediatrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/j.1398-9995.2012.02795.x","article-title":"Symptom profile and risk factors of anaphylaxis in Central Europe","volume":"67","author":"Worm","year":"2012","journal-title":"Allergy"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"A185","DOI":"10.1136\/archdischild-2015-308599.398","article-title":"G444 (P) An audit of the management of anaphylaxis in children in a district hospital","volume":"100","author":"Mclaughlin","year":"2015","journal-title":"Arch. Dis. Child"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"29","DOI":"10.5415\/apallergy.2016.6.1.29","article-title":"Anaphylaxis audit in a busy metropolitan Emergency Department: A review of real life management compared to best practice","volume":"6","author":"Murad","year":"2016","journal-title":"Asia Pac. Allergy"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.ienj.2012.01.004","article-title":"Management of anaphylaxis in the ED: A clinical audit","volume":"21","author":"Caton","year":"2013","journal-title":"Int. Emerg. Nurs."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.jaci.2003.10.053","article-title":"Multicenter study of emergency department visits for food allergies","volume":"113","author":"Clark","year":"2004","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1111\/cea.13821","article-title":"Factors associated with the underuse of adrenaline in children with anaphylaxis","volume":"51","author":"Pouessel","year":"2021","journal-title":"Clin. Exp. Allergy J. Br. Soc. Allergy Clin. Immunol."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/9\/1477\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:28:37Z","timestamp":1760142517000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/9\/1477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,9]]},"references-count":20,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["jpm12091477"],"URL":"https:\/\/doi.org\/10.3390\/jpm12091477","relation":{},"ISSN":["2075-4426"],"issn-type":[{"type":"electronic","value":"2075-4426"}],"subject":[],"published":{"date-parts":[[2022,9,9]]}}}