PDF(Pubmed)
Abstract：
Management of cow\'s milk protein allergy (CMPA) can vary depending on the experience and area of expertise of the clinician responsible for the patient\'s follow-up, which may or may not align with the recently published literature. To analyze the perspectives of Spanish pediatricians on this topic, a survey was conducted. The survey aimed to determine the current opinions and attitudes of 222 primary care and hospital pediatricians toward CMPA prevention and nutritional management. Participating pediatricians completed the questionnaire, providing insights into their daily clinical practices, including access to testing, attitudes with respect to various aspects of CMPA diagnosis, prevention, oral food challenges, and treatment. The findings revealed that pediatricians generally agree on the use of extensively hydrolyzed formulas (eHFs) to prevent CMPA in high-risk atopic children, despite limited evidence supporting the widespread use of this practice. However, consensus was lacking regarding the utility of formulas with prebiotics and probiotics for expediting tolerance development. In most cases, pediatricians preferred eHFs for the nutritional management of CMPA, followed by hydrolyzed rice formulas (HRFs), with amino-acid-based formulas (AAFs) being the third option. Certain issues remained controversial among pediatricians, such as prevention methods, symptom assessment, and the role of probiotics. These variations in management approaches reflect the influence of clinician experience and area of expertise, underscoring the need for standardized guidelines in this field.
摘要：
牛奶蛋白过敏（CMPA）的管理可能因负责患者随访的临床医生的经验和专业领域而异，这可能与最近出版的文献一致，也可能不一致。为了分析西班牙儿科医生对此主题的观点，进行了一项调查。该调查旨在确定222名初级保健和医院儿科医生对CMPA预防和营养管理的当前意见和态度。参与的儿科医生填写了问卷，提供他们日常临床实践的见解，包括进入测试，对CMPA诊断各个方面的态度，预防,口腔食物挑战，和治疗。研究结果表明，儿科医生普遍同意使用广泛水解配方（eHFs）来预防高危特应性儿童的CMPA，尽管支持广泛使用这种做法的证据有限。然而,关于用益生元和益生菌加速耐受性发展的配方的实用性缺乏共识。在大多数情况下,儿科医生更喜欢eHFs用于CMPA的营养管理，其次是水解大米配方(HRFs)，基于氨基酸的配方（AAF）是第三种选择。某些问题在儿科医生中仍然存在争议，如预防方法，症状评估,和益生菌的作用。管理方法的这些变化反映了临床医生经验和专业知识领域的影响，强调在这一领域需要标准化的指导方针。
