Methylxanthine use in anaphylaxis: What does the evidence tell us?

OBJECTIVE: To review the literature examining the use of methylxanthines in the treatment of anaphylaxis. DATA SOURCE: A MEDLINE search (January 1966-December 1998) was performed us ing the terms aminophylline, theophylline, and anaphylaxis. STUDY SELECTION AND DATA EXTRACTION: Articles discussing methylxanthine use in anaphylaxis were independently examined by each author. Additional info rmation was obtained through the references of these articles. Articles not written in English were excluded. DATA SYNTHESIS: No human studies were identified. Limited published data we re found in animal models of anaphylaxis. CONCLUSIONS: Safer agents with proven efficacy exist for the treatment of b ronchoconstriction in anaphylaxis. Until data are available in humans, meth ylxanthines should not be recommended in the treatment of anaphylactic reac tions.