• Of the 2621 food anaphylaxis cases, 731 (27.9%) were considered as severe (grade 3, [94%] and grade 4 [6%]; 19 deaths).
• There were more grade 4 anaphylaxis cases in children than in adults (p = 0.01).
• In the multivariate analysis, individuals with a grade 4 anaphylaxis were more likely to have a history of asthma (OR [95% CI]: 5.46 [2.02–14.73], p < 0.001), peanut and cow's milk as culprit food triggers (OR: 4.94 [1.50–16.23], p = 0.009; OR: 6.44 [1.20–34.56], p = 0.03; respectively), compared to individuals with grade 3 anaphylaxis.

This pharmacovigilance study identified the 15 most-reported drugs linked to anaphylaxis, including antibiotics and NSAIDs. The majority of drug-associated anaphylaxis reports were reported to occur within 2.5 h for most drugs. Despite being life-threatening yet recoverable, delayed recognition highlights the need for improved guidelines and enhanced pharmacovigilance systems for better management.