Prevention of anaphylaxis in healthcare settings

Expert Rev Clin Immunol. 2013 Sep;9(9):855-69. doi: 10.1586/1744666X.2013.828871.


In this paper, we review recent evidence on preventing anaphylaxis in healthcare settings and contexts where the risk of developing anaphylaxis is known to be increased. These include investigation units in which patients are undergoing challenge testing, outpatient clinics undertaking immunotherapy and vaccination, inpatient settings in which patients receive antibiotics, non-steroidal anti-inflammatory drugs, opiates and biological agents and operating theatres in which patients receive general anesthetics. Anaphylaxis may however develop unpredictably in any patient exposed to a wide range of drugs, food and other triggers (e.g., latex, iodinated contrast media and exercise), so it is important that all healthcare professionals and systems have effective, well-rehearsed protocols for risk assessment and management of this allergic emergency. Where available, we consider evidence for the effectiveness of interventions aiming to reduce the risk of developing anaphylaxis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anaphylaxis / diagnosis
  • Anaphylaxis / epidemiology
  • Anaphylaxis / prevention & control*
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Delivery of Health Care
  • Desensitization, Immunologic
  • Humans
  • Practice Guidelines as Topic / standards*
  • Risk Assessment
  • Risk Factors
  • Skin Tests


  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents, Non-Steroidal