Early Adrenaline Administration After Implementation of the Japanese Anaphylaxis Guideline 2014: A Single-Center...

Early administration of adrenaline is the cornerstone of anaphylaxis treatment; however, delays in its administration remain common in clinical practice. The Japanese Anaphylaxis Guideline, published in 2014, aimed to standardize the diagnosis and early treatment of anaphylaxis, but its impact on clinical practice has not been fully evaluated.

To evaluate the impact of guideline implementation on time to adrenaline, incidence of biphasic reactions, and length of hospital stay (LOS).

This single-center retrospective cohort study included 131 adult inpatients with anaphylaxis admitted between 2011 and 2022, categorized into a pre-guideline group (Group A, n = 55) and a post-guideline group (Group B, n = 76). Outcomes included time to adrenaline administration, incidence of biphasic reactions, and length of hospital stay (LOS).

Following guideline implementation, the median time to adrenaline administration was shorter (6.0-5.0 min, p = 0.040). The incidence of biphasic reactions decreased from 16.5% to 6.6%, although the difference was not statistically significant (p = 0.074). The median LOS decreased from 20.1 to 18.7 h, but this difference was also not statistically significant (p = 0.080).

Guideline implementation was associated with significantly earlier adrenaline administration, indicating improved treatment processes, whereas reductions in biphasic reactions and length of hospital stay did not reach statistical significance.