Use of Dexamethasone in Prevention of the Second Phase or a Biphasic Reaction of Anaphylaxis
Status:
Recruiting
Trial end date:
2022-09-01
Target enrollment:
Participant gender:
Summary
Anaphylaxis is an acute serious allergic reaction, with multi-organ system manifestations
caused by the release of chemical mediators and it is potentially fatal .
Between 5% and 14% of patients may experience a recurrence of anaphylaxis 8-12 hours after
the initial presentation, called biphasic (late-phase) .
The mainstay of treatment for children experiencing anaphylaxis remains adrenaline and
H1-antihistamines. Corticosteroids are not life-saving and do not have an immediate effect on
the symptoms of anaphylaxis but may help reduce or prevent a biphasic "late phase" reaction .
The aim of this study is to compare the efficacy of oral glucocorticoids in prevention of the
second phase or biphasic reaction of anaphylaxis, as compared to placebo in children,
presenting to the pediatric emergency department (PEC Al-Sadd) with mild to moderate
anaphylaxis (Prospective Study).
Patients will be randomized to either one of the two treatment:
Treatment 1: Dexamethasone 0.6mg/kg oral. Treatment 2 : Placebo All patients will be urgently
treated for anaphylaxis according to guideline protocol. Enrolled patients will be given one
of the study medications orally, and he /she will observe in the observation room with
cardiac monitor and close monitoring by nurse.
The treating physician will discharge patient when he/she looks well, breathing comfortably,
has oxygen saturation >94%, stable blood pressure and no gastrointestinal or neurological
manifestation.
Discharge patients will be sent home on anti-histamine (cetirizine) for 5days. All patients
will be followed up for one week post discharge by a phone call asking about the general
condition, relapse of symptoms, or need for readmission.