Background/Objectives: Evidence-based recommendations are vital in healthcare to standardize care, reduce variability, and improve patient outcomes. In children, anaphylaxis, allergy to antibiotics, and hymenoptera venom allergy are among the commonest reasons for allergological evaluation. This work was intended to optimize the prescriptions for allergological evaluation and for the related diagnostic tests with the aim of improving the management of children with allergic diseases and promoting resource efficiency. Methods: A systematic literature review of the literature was performed to formulate recommendations on the diagnostic management of children with anaphylaxis, drug allergy, and hymenoptera venom allergy. Results: Effective management of anaphylaxis involves rapid assessment and specialist follow-up to identify triggers, prevent recurrence, and ensure patients and caregivers are educated and equipped with an adrenaline auto-injector. Integrating skin testing, specific serological assays, and oral provocation tests into the diagnostic process for children with suspected beta-lactam allergy enhances diagnostic accuracy and minimizes unnecessary avoidance of first-line antibiotics. Children and adolescents with systemic reactions to hymenopteran stings should be referred to an allergy specialist for diagnosis, risk assessment, management education, and adrenaline prescription. Conclusions: These recommendations may enhance care quality, minimize inappropriate prescriptions, and support standardized methods of diagnosis of allergological diseases in children.
Evidence-Based Clinical Recommendations on the appropriateness of prescriptions and diagnostic tests in paediatrics allergology: Focus on Anaphylaxis, Drug Allergy and Hymenoptera Venom Allergy / Fainardi, Valentina; Riccò, Matteo; Antignani, Rachele; Bellodi, Simona; Buono, Enrico Vito; Calvani, Mauro; Carbone, Roberta; Cardinale, Fabio; Chiappini, Elena; Angiola Crivellaro, Maria; Cunico, Daniela; Esposito, Massimiliano; Licari, Amelia; Miraglia Del Giudice, Michele; Marsella, Maria; Neri, Iria; Nocerino, Rita; Peroni, Diego; Piersantelli, Cristina; Pingitore, Giuseppe; Squazzini, Giuseppe; Angela Tosca, Maria; Caffarelli, Carlo; Esposito, Susanna. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 15:(2026). [10.3390/jcm15020678]
Evidence-Based Clinical Recommendations on the appropriateness of prescriptions and diagnostic tests in paediatrics allergology: Focus on Anaphylaxis, Drug Allergy and Hymenoptera Venom Allergy
Valentina Fainardi;Enrico Vito Buono;Roberta Carbone;Daniela Cunico;Carlo Caffarelli;Susanna Esposito
2026-01-01
Abstract
Background/Objectives: Evidence-based recommendations are vital in healthcare to standardize care, reduce variability, and improve patient outcomes. In children, anaphylaxis, allergy to antibiotics, and hymenoptera venom allergy are among the commonest reasons for allergological evaluation. This work was intended to optimize the prescriptions for allergological evaluation and for the related diagnostic tests with the aim of improving the management of children with allergic diseases and promoting resource efficiency. Methods: A systematic literature review of the literature was performed to formulate recommendations on the diagnostic management of children with anaphylaxis, drug allergy, and hymenoptera venom allergy. Results: Effective management of anaphylaxis involves rapid assessment and specialist follow-up to identify triggers, prevent recurrence, and ensure patients and caregivers are educated and equipped with an adrenaline auto-injector. Integrating skin testing, specific serological assays, and oral provocation tests into the diagnostic process for children with suspected beta-lactam allergy enhances diagnostic accuracy and minimizes unnecessary avoidance of first-line antibiotics. Children and adolescents with systemic reactions to hymenopteran stings should be referred to an allergy specialist for diagnosis, risk assessment, management education, and adrenaline prescription. Conclusions: These recommendations may enhance care quality, minimize inappropriate prescriptions, and support standardized methods of diagnosis of allergological diseases in children.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.


