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After reviewing the published evidence, the authors state that the use of corticosteroids has no role in the acute management of anaphylaxis. These include histamine h 1 and h 2 antagonists, corticosteroids, beta 2 agonists, and glucagon. However, data doesn't seem to support this.

A cochrane review published in 2013 concluded that there is no evidence from high quality st dies for the use of steroids in the emergency management of anaphylaxis (19) Only after epinephrine administration should adjunct medications be considered Most episodes of anaphylaxis begin quickly, escalate, and then resolve completely, particularly when appropriate treatment is administered

However, some anaphylactic reactions resolve and recur hours later or do not resolve completely despite adequate treatment.

A systematic review of 31 studies found that corticosteroids did not prevent biphasic anaphylaxis, and their use was not recommended due to potential adverse effects 2. Corticosteroids and antihistamines more often than epinephrine for suspected anaphylaxis Among ed patients with allergic reactions or anaphylaxis, corticosteroid use was not associated with decreased relapses to additional care within 7 days Epinephrine treats all symptoms of anaphylaxis and can prevent the escalation of symptoms

Im is preferred, being faster and safer Use of adjunctive medications should not delay epinephrine administration. Because of the potential detrimental adverse effects of corticosteroids and lack of compelling evidence demonstrating an effective role in reducing anaphylaxis severity or preventing biphasic anaphylaxis, we do not advocate for their routine use in anaphylaxis.

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