INDICATIONS OF UNDERUTILIZATION OF EPINEPHRINE AUTO-INJECTORS IN THE FACE OF THE INCREASING CASES OF PEDIATRIC ANAPHYLAXIS
DOI:
https://doi.org/10.56238/arev8n1-127Keywords:
Epinephrine, Anaphylaxis, PediatricsAbstract
Anaphylaxis is an acute, systemic, and potentially life-threatening hypersensitivity reaction whose incidence has increased significantly in the pediatric population. Epinephrine is recognized as the first-line treatment for anaphylaxis, with the auto-injectable formulation being the safest option for early administration. However, evidence indicates frequent underutilization of this medication, which may compromise clinical outcomes. Therefore, this study aimed to analyze, through an integrative literature review, the scientific evidence regarding the indications and underutilization of epinephrine auto-injectors in the management of pediatric anaphylaxis. The methodology consisted of an integrative review guided by the PRISMA 2020 recommendations and structured according to the PICO strategy. Searches were conducted in the PubMed, BVS, and LILACS databases, including original articles published between 2020 and 2025 in Portuguese, English, and Spanish. After applying the eligibility criteria, nine studies were included in the final sample. The findings demonstrated that, despite the well-established efficacy and safety of epinephrine, its use in pediatric patients remains heterogeneous. Factors such as delayed recognition of anaphylaxis, professional uncertainty, limited access to auto-injectors, and inadequate follow-up after hospital discharge contributed to the underutilization of epinephrine. Recent studies also highlighted that emerging technologies, such as intranasal epinephrine, may facilitate timely administration and reduce hesitation in its use. In conclusion, the underutilization of epinephrine auto-injectors in pediatrics is not related to a lack of scientific evidence, but rather to clinical, educational, and structural barriers. Integrated strategies, including continuous professional training, standardized clinical protocols, and expanded access to epinephrine auto-injectors, are essential to improve anaphylaxis management and reduce pediatric morbidity and mortality.
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