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Lactose-Containing Dry-Powder Inhalers for Patients with Cow’s Milk Protein Allergy—The Conundrum; A National Survey of Pediatric Pulmonologists and Allergologists
Introduction: Several dry-powder inhalers (DPIs) contain lactose which may be contaminated with milk proteins. Confusion exists pertaining to DPI use in patients with cow’s milk protein allergy (CMPA). Methods: A computerized survey sent via e-mail to pediatric pulmonologists and allergologists. Res...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9785354/ https://www.ncbi.nlm.nih.gov/pubmed/36555964 http://dx.doi.org/10.3390/jcm11247346 |
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author | Bar-On, Ophir Levine, Hagit Stafler, Patrick Shmueli, Einat Jacobi, Eyal Goldberg, Ori Steuer, Guy Prais, Dario Mei-Zahav, Meir |
author_facet | Bar-On, Ophir Levine, Hagit Stafler, Patrick Shmueli, Einat Jacobi, Eyal Goldberg, Ori Steuer, Guy Prais, Dario Mei-Zahav, Meir |
author_sort | Bar-On, Ophir |
collection | PubMed |
description | Introduction: Several dry-powder inhalers (DPIs) contain lactose which may be contaminated with milk proteins. Confusion exists pertaining to DPI use in patients with cow’s milk protein allergy (CMPA). Methods: A computerized survey sent via e-mail to pediatric pulmonologists and allergologists. Results: A total of 77 out of 232 (33.2%) doctors replied, of whom 80.5% were pediatric pulmonologists. A total of 69 of 77 (89.6%) were specialists, 37.6% with more than 15 years of experience. The most commonly used DPIs were formoterol + budesonide and vilanterol + fluticasone. A total of 62 out of 77 (80.5%) responders knew these DPIs contained lactose. A total of 35 out of 77 (45.5%) doctors who replied did not know that DPI leaflets list CMPA as a contra-indication to DPI administration. Of these, 4 (11.4%) stated that they would instruct patients with CMPA to stop DPIs, and 7 (20%) would avoid recommending DPIs. A total of 42 out of 77 (54.5%) responders were aware of this warning, yet 13 of these 42 (30.9%) continued to recommend lactose-containing DPIs without hesitation and 18 of these 42 (42.8%) responders prescribed DPIs but considered allergy severity. Conclusions: Almost half of certified, experienced pediatric pulmonologists and allergologists were unaware of the warning to administer DPIs to patients with CMPA. Most doctors who do know of this warning still continue to prescribe these DPIs. |
format | Online Article Text |
id | pubmed-9785354 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-97853542022-12-24 Lactose-Containing Dry-Powder Inhalers for Patients with Cow’s Milk Protein Allergy—The Conundrum; A National Survey of Pediatric Pulmonologists and Allergologists Bar-On, Ophir Levine, Hagit Stafler, Patrick Shmueli, Einat Jacobi, Eyal Goldberg, Ori Steuer, Guy Prais, Dario Mei-Zahav, Meir J Clin Med Article Introduction: Several dry-powder inhalers (DPIs) contain lactose which may be contaminated with milk proteins. Confusion exists pertaining to DPI use in patients with cow’s milk protein allergy (CMPA). Methods: A computerized survey sent via e-mail to pediatric pulmonologists and allergologists. Results: A total of 77 out of 232 (33.2%) doctors replied, of whom 80.5% were pediatric pulmonologists. A total of 69 of 77 (89.6%) were specialists, 37.6% with more than 15 years of experience. The most commonly used DPIs were formoterol + budesonide and vilanterol + fluticasone. A total of 62 out of 77 (80.5%) responders knew these DPIs contained lactose. A total of 35 out of 77 (45.5%) doctors who replied did not know that DPI leaflets list CMPA as a contra-indication to DPI administration. Of these, 4 (11.4%) stated that they would instruct patients with CMPA to stop DPIs, and 7 (20%) would avoid recommending DPIs. A total of 42 out of 77 (54.5%) responders were aware of this warning, yet 13 of these 42 (30.9%) continued to recommend lactose-containing DPIs without hesitation and 18 of these 42 (42.8%) responders prescribed DPIs but considered allergy severity. Conclusions: Almost half of certified, experienced pediatric pulmonologists and allergologists were unaware of the warning to administer DPIs to patients with CMPA. Most doctors who do know of this warning still continue to prescribe these DPIs. MDPI 2022-12-10 /pmc/articles/PMC9785354/ /pubmed/36555964 http://dx.doi.org/10.3390/jcm11247346 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Bar-On, Ophir Levine, Hagit Stafler, Patrick Shmueli, Einat Jacobi, Eyal Goldberg, Ori Steuer, Guy Prais, Dario Mei-Zahav, Meir Lactose-Containing Dry-Powder Inhalers for Patients with Cow’s Milk Protein Allergy—The Conundrum; A National Survey of Pediatric Pulmonologists and Allergologists |
title | Lactose-Containing Dry-Powder Inhalers for Patients with Cow’s Milk Protein Allergy—The Conundrum; A National Survey of Pediatric Pulmonologists and Allergologists |
title_full | Lactose-Containing Dry-Powder Inhalers for Patients with Cow’s Milk Protein Allergy—The Conundrum; A National Survey of Pediatric Pulmonologists and Allergologists |
title_fullStr | Lactose-Containing Dry-Powder Inhalers for Patients with Cow’s Milk Protein Allergy—The Conundrum; A National Survey of Pediatric Pulmonologists and Allergologists |
title_full_unstemmed | Lactose-Containing Dry-Powder Inhalers for Patients with Cow’s Milk Protein Allergy—The Conundrum; A National Survey of Pediatric Pulmonologists and Allergologists |
title_short | Lactose-Containing Dry-Powder Inhalers for Patients with Cow’s Milk Protein Allergy—The Conundrum; A National Survey of Pediatric Pulmonologists and Allergologists |
title_sort | lactose-containing dry-powder inhalers for patients with cow’s milk protein allergy—the conundrum; a national survey of pediatric pulmonologists and allergologists |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9785354/ https://www.ncbi.nlm.nih.gov/pubmed/36555964 http://dx.doi.org/10.3390/jcm11247346 |
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