TOPLINE:

Older adults with anaphylaxis had higher rates of drug and venom triggers than younger adults and were more frequently admitted to the ICU. They received less epinephrine and were less likely to have food-induced anaphylaxis.

METHODOLOGY:

• Researchers analyzed data from a database of anaphylactic cases from three Canadian provinces from April 2011 to May 2024 to compare anaphylactic triggers, symptomatology, and management between adults aged 64 years or younger and older adults.
• Of 1135 patients evaluated, 1045 (median age, 34 years; 38.1% men) were younger adults and 90 (median age, 70.3 years; 38% men) were older adults.

TAKEAWAY:

• Older adults had a higher prevalence of drug allergy (P < .01) and food-induced anaphylaxis (P = .03) than younger adults.
• Older adults were more likely than younger adults to be admitted to the ICU (P = .04).
• The inpatient use of epinephrine was significantly lower in older adults (P = .03) than in younger adults.
• Younger adults were more likely to experience food-induced anaphylaxis than older adults (P < .01).

IN PRACTICE:

“Clinicians should be particularly alert to drug- and venom-induced anaphylaxis in elderly patients and ensure early administration of epinephrine, regardless of the presence of cardiovascular comorbidities,” the authors wrote. “Education on auto-injector use and prompt recognition of anaphylaxis should be reinforced in this age group to reduce delays in treatment,” they added.

SOURCE:

Roy Khalaf, MD, with McGill University, Montreal, Quebec, Canada, was the corresponding author of this study, which was published online on September 9, 2025, in International Archives of Allergy and Immunology.

LIMITATIONS:

The higher prevalence of asthma among retrospective cases, the reliance on retrospective data, and the focus on emergency department presentations may have limited the generalizability of the findings. Additionally, the association between medication use and ICU admission and the decision-making process regarding epinephrine use in older patients were not explored.

DISCLOSURES:

The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.