The USA, European, and international guidelines (World Allergy Organization [WAO]) all recommend epinephrine as the drug of choice for all causes of anaphylaxis including food-induced anaphylaxis.65 The appropriate dose should be promptly administered upon onset of symptoms. Failure to receive epinephrine in a timely manner is a risk factor for fatality due to anaphylaxis, and studies have demonstrated that epinephrine is administered in only 25%–44% of patients with anaphylactic reactions.55,56,66 Additional therapies for anaphylactic reactions include supplemental oxygen and volume repletion for hypotension when appropriate. Symptom-specific adjunctive therapies may also be considered. These would include bronchodilators for wheezing and H1-antihistamines for pruritus, cutaneous symptoms, or rhinorrhea. Systemic corticosteroids in the acute management of anaphylaxis have been shown to be of questionable value, though they are routinely used as a second-line agent for possible prevention of late-phase reactions.67