Pediatricians are aware of the 2017 Addendum Guidelines for the Prevention of Peanut Allergy in the United States, but many have not fully implemented them in their practices, according to study results published in JAMA Network Open.

An electronic survey instrument consisting of 29-items was emailed to all pediatricians in the American Academy of Pediatrics vendor database in 2018. Eligibility was determined to be currently practicing pediatricians who provide general care to infants aged ≤12 months. The primary outcome was the prevalence of guideline implementation. Secondary outcomes included identification of guidelines-focused services provided by pediatricians, knowledge of the guidelines, and barriers to guideline implementation.

Of the 41,048 eligible pediatricians who were sent an invitation to the survey, 1781 completed the entire survey. Of these 1781, 72.5% self-identified as white and 67.4% as women. Overall, 93.4% of pediatricians reported being aware of the guidelines. However, only 28.9% reported full implementation, with 64.3% reporting partial implementation. Parental concerns about allergic reactions was listed as a common barrier to implementation.

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“Pediatrician awareness and partial implementation of the 2017 Addendum Guidelines for the Prevention of Peanut Allergy in the United States appeared to be high; however, full implementation of the guidelines seemed low,” the study authors wrote. “We believe the results of this survey study will inform interventions that target barriers to pediatrician guideline adherence and thereby reduce the incidence of peanut allergy in infants.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Gupta RS, Bilaver LA, Johnson JL, et al. Assessment of pediatrician awareness and implementation of the addendum guidelines for the prevention of peanut allergy in the United States [published online July 15, 2020].  JAMA Netw Open.doi:10.1001/jamanetworkopen.2020.10511