title: Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel.
abstract: BACKGROUND
  Food allergy is an important public health problem because it affects children and adults, can be severe and even life-threatening, and may be increasing in prevalence. Beginning in 2008, the National Institute of Allergy and Infectious Diseases, working with other organizations and advocacy groups, led the development of the first clinical guidelines for the diagnosis and management of food allergy. A recent landmark clinical trial and other emerging data suggest that peanut allergy can be prevented through introduction of peanut-containing foods beginning in infancy.
  
  
  OBJECTIVE
  Prompted by these findings, along with 25 professional organizations, federal agencies, and patient advocacy groups, the National Institute of Allergy and Infectious Diseases facilitated development of addendum guidelines to specifically address the prevention of peanut allergy.
  
  
  RESULTS
  The addendum provides 3 separate guidelines for infants at various risk levels for the development of peanut allergy and is intended for use by a wide variety of health care providers. Topics addressed include the definition of risk categories, appropriate use of testing (specific IgE measurement, skin prick tests, and oral food challenges), and the timing and approaches for introduction of peanut-containing foods in the health care provider's office or at home. The addendum guidelines provide the background, rationale, and strength of evidence for each recommendation.
  
  
  CONCLUSIONS
  Guidelines have been developed for early introduction of peanut-containing foods into the diets of infants at various risk levels for peanut allergy.
authors.affiliation: National Institute of Allergy and Infectious Diseases, Bethesda, Md.
authors.forename: Alkis
authors.initials: A
authors.lastname: Togias
authors.affiliation: National Institute of Allergy and Infectious Diseases, Bethesda, Md. Electronic address: coopersu@niaid.nih.gov.
authors.forename: Susan F
authors.initials: SF
authors.lastname: Cooper
authors.affiliation: Board of Directors, Food Allergy Research & Education, McLean, Va.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Acebal
authors.affiliation: Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Amal
authors.initials: A
authors.lastname: Assa'ad
authors.affiliation: Food Allergy Research & Education, McLean, and the Division of Allergy and Clinical Immunology, University of Michigan Health System, Ann Arbor, Mich.
authors.forename: James R
authors.initials: JR
authors.lastname: Baker
authors.affiliation: Department of Dermatology, University of Rochester Medical Center, NY.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Beck
authors.affiliation: National Eczema Association, San Rafael, Calif.
authors.forename: Julie
authors.initials: J
authors.lastname: Block
authors.affiliation: Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ.
authors.forename: Carol
authors.initials: C
authors.lastname: Byrd-Bredbenner
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Edmond S
authors.initials: ES
authors.lastname: Chan
authors.affiliation: Departments of Dermatology and Pediatrics, University of California, San Diego School of Medicine, Rady Children's Hospital, San Diego, Calif.
authors.forename: Lawrence F
authors.initials: LF
authors.lastname: Eichenfield
authors.affiliation: Section of Allergy and Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, Colo.
authors.forename: David M
authors.initials: DM
authors.lastname: Fleischer
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Kentucky College of Medicine, Kentucky Children's Hospital, Lexington, Ky.
authors.forename: George J
authors.initials: GJ
authors.lastname: Fuchs
authors.affiliation: Digestive Health Institute, Children's Hospital Colorado, Aurora, and the Section of Pediatric Gastroenterology, University of Colorado Denver School of Medicine, Aurora, Colo.
authors.forename: Glenn T
authors.initials: GT
authors.lastname: Furuta
authors.affiliation: Section of Allergy and Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, Colo.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Greenhawt
authors.affiliation: Division of Academic General Pediatrics and Primary Care, Department of Pediatrics, and the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Ill.
authors.forename: Ruchi S
authors.initials: RS
authors.lastname: Gupta
authors.affiliation: Northwestern Medicine, Central DuPage Hospital, Winfield, Ill.
authors.forename: Michele
authors.initials: M
authors.lastname: Habich
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Ark.
authors.forename: Stacie M
authors.initials: SM
authors.lastname: Jones
authors.affiliation: Metro DC Food Allergy Support Group, Rockville, Md.
authors.forename: Kari
authors.initials: K
authors.lastname: Keaton
authors.affiliation: Food Allergy Referral Centre, Department of Women and Child Health, Padua University Hospital, Padua, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Muraro
authors.affiliation: National Institute of Allergy and Infectious Diseases, Bethesda, Md.
authors.forename: Marshall
authors.initials: M
authors.lastname: Plaut
authors.affiliation: University of Missouri-Kansas City School of Medicine, Kansas City, Mo.
authors.forename: Lanny J
authors.initials: LJ
authors.lastname: Rosenwasser
authors.affiliation: National Institute of Allergy and Infectious Diseases, Bethesda, Md.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rotrosen
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Hugh A
authors.initials: HA
authors.lastname: Sampson
authors.affiliation: Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass.
authors.forename: Lynda C
authors.initials: LC
authors.lastname: Schneider
authors.affiliation: Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Scott H
authors.initials: SH
authors.lastname: Sicherer
authors.affiliation: Department of Pediatrics, Division of Dermatology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash.
authors.forename: Robert
authors.initials: R
authors.lastname: Sidbury
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pa.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Spergel
authors.affiliation: Department of Pediatrics, Section of Allergy and Immunology, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: David R
authors.initials: DR
authors.lastname: Stukus
authors.affiliation: Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Carina
authors.initials: C
authors.lastname: Venter
authors.affiliation: Departments of Medicine and Pediatrics, Harvard Medical School, Boston, Mass.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Boyce
mesh_terms: D000485:Allergens / Q000276:immunology; D010367:Arachis / Q000276:immunology; D004485:Eczema / Q000175:diagnosis; D021181:Egg Hypersensitivity / Q000175:diagnosis; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D054579:National Institute of Allergy and Infectious Diseases (U.S.); D021183:Peanut Hypersensitivity / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control*; D012882:Skin Tests; D014481:United States
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: Food; allergy; guidelines; peanut; prevention