Itazawa T, Adachi Y, Takahashi Y, et al. - In this prospective multicenter study run from March 2012 to May 2013, researchers investigated how the indication for oral food challenges (OFCs) influences the prevalence, severity, and treatment of allergic reactions. They analyzed 5,062 cases (median age, 3.8 years; males, 65.2%). In 2,258 (44.6%) OFCs, allergic reactions were evoked: grade 1 were 991 (43.9%), grade 2 were 736 (32.6%), grade 3 were 340 (15.1%), and grade 4-5 were 191 (8.5%). In 7.1% (n = 160) of positive OFCs, epinephrine was given. Based on the indication for OFC, a significant difference was evident in the severity, among the top three most common food allergens (hen’s egg, cow’s milk, and wheat), and higher severity of allergic reactions was noted for the indication to evaluate threshold level for oral immunotherapy, as suggested by adjusted standardized residuals. For the indication to ascertain safe intake quantity, the highest prevalence of epinephrine use was observed. Overall, findings revealed a difference in the prevalence, severity, and treatment of allergic reactions, based on the indication for OFC.