Study Reveals Excessive Hospitalization Times for Children with Allergic Reactions

A recent study conducted by researchers at Cincinnati Children's Hospital Medical Center has unveiled that many children suffering from acute allergic reactions often spend unnecessary hours in hospital observation. Published on June 10, 2025, in the *Lancet: Child and Adolescent Health*, the study analyzed over 5,600 emergency visits across 31 hospitals in the United States and Canada, highlighting a critical issue in pediatric emergency care related to anaphylaxis treatment.

According to Dr. Tim Dribin, an emergency medicine physician at Cincinnati Children's and lead author of the study, the findings suggest that 95% of children treated with a dose of epinephrine could be safely discharged within two hours, and 98% within four hours. This contrasts sharply with the current practice, where many hospitals routinely keep patients for observation well beyond these time frames.

The research indicates a significant increase in pediatric emergency department visits for allergic reactions, which more than tripled from 2008 to 2016. Allergens such as peanuts, eggs, and shellfish are common triggers that cause families to live under the constant fear of sudden allergic reactions. Dr. Dribin explained, "Years ago, we used to admit virtually all kids with anaphylaxis to the hospital. We have stopped doing that, but most hospitals still routinely observe kids for over four hours, some even longer."

The study's methodology involved analyzing data from 5,641 cases where children received epinephrine injections for anaphylaxis. Most patients (approximately 90%) experienced food-related allergic reactions, while others were triggered by medications or insect stings. Alarmingly, about 17% of children were admitted for overnight observation, with some remaining in emergency departments for extended periods. The research identified that only 4.7% of patients required a second dose of epinephrine within two hours, and 1.9% after four hours.

Dr. David Schnadower, director of the Division of Emergency Medicine at Cincinnati Children's, noted the strain that prolonged observation times can place on pediatric emergency departments, especially during peak seasons for respiratory illnesses. He emphasized the need for efficient throughput to ensure access for all patients. "This study provides strong evidence that discharging patients showing no concerning symptoms in less than two hours is safe for most children," he stated.

While the study did not calculate the potential cost savings from reduced hospital admissions, the authors believe substantial reductions in unnecessary hospital stays could lead to faster recovery times for families and children. Dr. Hugh Sampson, an allergist at the Icahn School of Medicine at Mount Sinai, concurred, stating that expediting discharge may encourage families to seek emergency help sooner, reducing the risks associated with delayed treatment.

The study was supported by funding from the National Center for Advancing Translational Sciences and the National Institute of Allergy and Infectious Diseases. As pediatric emergency care evolves, these findings challenge existing protocols and suggest a shift toward more efficient care that empowers families with choices, ultimately aiming for better health outcomes while alleviating the burden on healthcare resources.