D3.341 - Alignment with International Anaphylaxis Management Guidelines in a Tertiary Referral Center in Central Asia: A Retrospective Clinical Audit

Anaphylaxis is a severe, potentially life-threatening systemic hypersensitivity reaction that requires immediate recognition and prompt intramuscular epinephrine administration. International guidelines consistently define epinephrine as first-line treatment. Nevertheless, variability in implementation has been reported globally. Data from Central Asia are scarce. This study aimed to evaluate real-world management patterns of anaphylaxis and assess alignment with guideline-recommended care in a tertiary referral setting.

We conducted a retrospective clinical audit of consecutive patients diagnosed with anaphylaxis at a tertiary allergy center between January 2023 and December 2025. Diagnosis was established according to accepted clinical criteria. Data extracted from medical records included demographic characteristics, suspected triggers, organ system involvement, initial management prior to referral, timing of epinephrine administration, and hospitalization rates. The primary outcome was adherence to guideline-recommended first-line intramuscular epinephrine use. The study was conducted in accordance with institutional ethical standards. Descriptive statistical analysis was performed.

Twenty-three patients were included (median age 31 years; 65% female). The most common triggers were medications (39%), foods (35%), and insect stings (13%). Cutaneous and respiratory manifestations were present in the majority of cases, and cardiovascular involvement was documented in a subset of patients. Epinephrine was administered in 52% of cases. In the remaining patients, antihistamines and/or systemic corticosteroids were used prior to epinephrine or without epinephrine administration. Delayed administration of epinephrine was observed in several cases. Hospitalization was required in 43% of patients. No fatalities occurred.

This real-world audit demonstrates variability in alignment with international anaphylaxis management guidelines, particularly regarding timely first-line epinephrine administration. These findings underscore the need for targeted physician education, standardized emergency algorithms, and structured quality improvement initiatives. Region-specific data are essential to inform implementation strategies aligned with the “Vision Zero” objective of reducing preventable severe allergic outcomes. Prospective multicenter studies are warranted to further characterize regional practice patterns.