Saturday, June 26, 2010

Summertime Tips for Food-Allergic Partygoers

Excellent Article from the American College of Allergy, Asthma & Immunology- reposted with permission.

Summer Means Barbecues, Picnics – and Food Allergies
Ants, bees and rain aren’t the only things that can put a damper on a picnic or barbecue. For more than 12 million Americans food allergies can ruin the fun too, by causing problems ranging from the mild (itchy bumps and stomach aches) to the severe and life-threatening (swelling of the throat and difficulty breathing).
Be food allergy savvy at your next picnic, whether you are planning the event or have food allergies yourself. The American College of Allergy, Asthma and Immunology offers the following tips for keeping food allergies off the menu:
  • Consider condiment packs – Instead of large containers of condiments, use individual-sized packets of ketchup, mustard, relish and mayonnaise. These condiment packs will prevent cross contamination that can occur when sharing large containers.
  • Pack foods separately When preparing for a get-together away from home, pack allergic and non-allergic foods in separate containers.
  • Use a plastic tablecloth – In addition to dressing up your barbecue or picnic, a tablecloth prevents guests from coming in contact with any allergy-causing food particles left on the table from previous meals.
  • Provide a serving utensil for each food item – Separate utensils help reduce cross contamination between dishes. And be sure you have enough plates, cups, napkins and utensils so no one will have to share.
  • Carry medications – If you or a loved one has had allergic reactions to food in the past, be sure to have emergency medications on hand just in case unrecognized food allergens are hiding in picnic treats.
  • Serve allergic guests first – Grill foods for guests with allergies first, or cook the items on a fresh piece of aluminum foil.  Also, allow guests with allergies to dig into the food first, before cross-contamination of items can occur.
  • Remember the wipes – For get-togethers in forest preserves and other natural areas, soap and water might be tough to come by, so come prepared with disinfecting wipes and anti-bacterial gel.   Cleaning hands and faces after eating helps reduce the likelihood of allergy-causing food particles being passed during play.
  • Check cell phone coverage – If your picnic or barbecue is away from home, be sure you can get a cell phone signal in the area to call 911 if someone has a severe allergic reaction.
If you are a loved one experience an allergic reaction to food, it’s important to see an allergist, who can pinpoint which food is causing the reaction and develop a plan for avoiding it.
For more information about allergies and asthma, visit www.AllergyAndAsthmaRelief.org.

Saturday, June 12, 2010

Illinois State Board of Education Publishes Food Allergy Guidelines!

Thanks to the Mothers of Children Having Allergies (MOCHA) group for the following update!

Illinois State Board of Education (ISBE), in conjunction with the Illinois Department of Public Health (IDPH), has released the Guidelines for Managing Life-Threatening Food Allergies in Illinois Schools.


According to State Law, each local school board is required to have a policy based on these guidelines in place by Januray 2011- a sample policy based on these guidelines will be made available to all school districts in August. With any luck, the school boards will simply adopt the recommended sample policy- this is the expectation.

The guidelines and associated forms are available online at: http://www.isbe.net/nutrition/htmls/food_allergy_guidelines.htm The sample policy will be available to member school districts and to any non-member school district that requests a copy.

Even if you don't live in Illinois, this can be an excellent starting point as your food-allergic child prepares to enter the school system. If your school administrators feel uncomfortable with developing their own policy for protecting children with life-threatening food allergies, they may be able to request a copy if ISBE's policy to implement.

Wednesday, June 9, 2010

Antibiotic Choices in Acute Ear Infections- Does Convenience Lead to Treatment Failure?

Macrolide antibiotics (such as azithromycin) are popular choices when treating acute ear infections in children due to a short (5 day) course of treatment, once-daily dosing, and low incidence of gastrointestinal side effects.

However, macrolide antibiotics, while generally effective against the most common pathogens in acute ear infections in children (streptococcus pneumoniae, haemophilus influenzae, and moraxella catarrhalis), are quickly losing effectiveness as resistant strains of bacteria increase. A 2007 study by the CDC demonstrated a 22.7% rate of macrolide resistance among strep. pneumoniae isolates (the most common cause of ear infections).

2004 recommendations from the American Academy of Pediatrics and the American Academy of Family Physicians advised against the use of macrolides for acute ear infections unless a patient has an immediate-type allergic reaction to penicillin. However, the rate of macrolide prescription continues to dwarf the documented rate of immediate-type penicillin allergy.

A recent meta-analysis (a study of a compliation of other studies) published in The Annals of Pharmacotherapy confirmed that this is not a good trend. Although the rate of side effects (including diarrhea) was lower in the patients treated with macrolides when compared to those patients treated with the recommended antibiotics (amoxicillin or amoxicillin/clavulate), the macrolide-treated patients were more likely to still have untreated infection present at 10-16 day follow-up.

So, when your child is diagnosed with an acute ear infection, ask the following questions:
1. Does this infection require treatment with antibiotics? (over the age of 2 years, your physician may recommend 48 hours of watchful waiting before antibiotics are given)
2. Can my child be treated with amoxicillin or amoxicillin/clavulanate?
3. What can I do to decrease the chances that my child will experience untoward side effects from the antibiotic therapy? (I generally recommend taking the medication after a meal, and often add probiotics and yogurt to decrease the risk of gastrointestinal symptoms)

Don't fall into the convenience trap- it may cost you (and your little one) in the long run!

If a drug allergy is suspected, don't hesitate to consult a Board-certified Allergist & Immunologist- I often find that patients have spent many years avoiding a particular medication and using inferior substitutes due to overdiagnosis of drug hypersensitivity.