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Anaphylaxis management: Knowledge and practice among pediatricians in Kuwait

Maysoun Al Rushood

Background: Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Intramuscular Epinephrine is the treatment of choice. It has been shown that failure or delay in administering epinephrine is associated with increasing severity of the reaction and death. Many studies have demonstrated that the actual use of epinephrine is suboptimal. This is the first study on anaphylaxis in Kuwait. Objective: The aim is to assess the knowledge on anaphylaxis management among pediatricians and to determine the factors influencing their practice. Methods: This was a cross-sectional survey among general pediatricians. The questionnaire comprised of 18 questions, covering demographic information besides information on both acute management of anaphylaxis and patient disposition following recovery. The survey period was from April 2015 to December 2015. Results: 110 general pediatricians completed the questionnaire with a response rate of 50.4%. 53 were males (50.4%) and 57 were females (51%), with almost homogeneous distribution among the four main hospitals in Kuwait. 69.1% chose epinephrine as the first medication. The right dose of epinephrine was correctly chosen by 64.5% and 60% decided to give it intramuscularly, while only 30% of all respondents answered all the 3 entities correctly (IM epinephrine as the first medication in the right dose). The hospital of practice and the place of practice were important factors in determining the choice of the first medication. Conclusion: In Kuwait, the knowledge on anaphylaxis management among general pediatricians is suboptimal. Programs to improve their knowledge and practice are warranted.