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Effects of Glucocorticoids on Hospitalized Children With Anaphylaxis

Yusuke Okubo, Nobuaki Michihata1, Naho Morisaki2

  • 1Department of Health Services Research, Graduate School of Medicine, The University of Tokyo.

Pediatric Emergency Care
|June 19, 2018
PubMed

Insights

Glucocorticoid treatment for pediatric anaphylaxis did not increase readmission risk but prolonged hospital stays and raised costs. H1- and H2-receptor antagonist use increased during this period.

Area of Science:

  • Pediatric Allergy and Immunology
  • Clinical Pharmacology
  • Health Services Research

Background:

  • The benefits of glucocorticoid treatment for anaphylaxis are not well-established.
  • Recent trends in adjunctive treatments for anaphylaxis require investigation.

Purpose of the Study:

  • To examine recent practice patterns in pediatric anaphylaxis management.
  • To compare the effects of glucocorticoid administration in children hospitalized for anaphylaxis.

Main Methods:

  • Utilized the Japanese Diagnosis Procedure Combination inpatient database (2010-2014).
  • Compared length of hospital stay, 10-day readmission risk, and hospitalization costs between steroid and non-steroid groups.
  • Evaluated trends in adjunctive treatments, including H1-receptor antagonists and H2-receptor antagonists.

Main Results:

  • H1-receptor antagonist use increased from 65.1% to 71.8% (Ptrend=0.02), and H2-receptor antagonist use increased from 12.8% to 16.7% (Ptrend=0.01).
  • Glucocorticoid use remained stable (86.7% to 82.6%; Ptrend=0.08).
  • Steroid group had longer hospital stays (0.39 days) and higher costs (¥3896) but similar 10-day readmission risks compared to the non-steroid group.

Conclusions:

  • H1- and H2-receptor antagonist use is increasing in pediatric anaphylaxis management.
  • Glucocorticoid treatment for pediatric anaphylaxis is associated with increased hospital length of stay and total cost, without affecting readmission risk.
Abstract

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