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Initial treatment modes include hydration, occlusive topical medicines, antimicrobial treatment, phototherapy, and systemic immune suppressants in the case of severe to moderate refractory AD. However, there is a lack of head\u2010to\u2010head studies on the choice of topical and systemic therapies for moderate to severe AD in the pediatric age group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This systematic review aimed to determine the efficacy and safety of topical and systemic treatments for moderate\u2010to\u2010severe AD in the pediatric age group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A systematic review was performed following the Preferred Reporting Items for Systemic Reviews and Meta\u2010Analyses (PRISMA) guidelines. A search of articles was done from PubMed and Google Scholar from 1975 to 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found a total of 1114 possible clinical trials. Of these, 68 articles fulfilled the eligibility criteria. Thirty\u2010four articles discussed\u00a0topical therapies, which included corticosteroids, calcineurin inhibitors, and emollients, and 34 articles were about systemic therapies, consisting of cyclosporine, dupilumab, upadacitinib, thymopentin, omalizumab, antihistamines, probiotics, and others. Out of 68 studies, 41 were randomized controlled trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on the study results, we conclude that topical steroids and calcineurin inhibitors are effective and safe in mild to moderate pediatric AD. It was also demonstrated that while systemic monotherapy with dupilumab (in age groups younger than 6\u2009months) and JAK inhibitors (like abrocitinib and upadacitinib in those younger than 12\u2009years) is highly effective in rapidly reducing severity scores, their high cost and limited availability restrict their use in countries like India. In such settings, cyclosporine (and sometimes oral prednisolone in tapering doses over 2\u2009weeks) is still recommended as a first\u2010line therapy in severe AD while planning for steroid\u2010sparing agents.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.17723","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T23:14:37Z","timestamp":1742253277000},"page":"1255-1266","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evidence\u2010Based Recommendations for Managing Atopic Dermatitis in Pediatric Patients: A Systematic Review and Meta\u2010Analysis From the Pediatric Dermatology Special Interest Group of <scp>IADVL<\/scp>"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4320-3193","authenticated-orcid":false,"given":"Rahul","family":"Mahajan","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology, and Leprology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8768-4879","authenticated-orcid":false,"given":"Rashmi","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of Dermatology Lady Hardinge Medical College and Hospitals  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2919-2953","authenticated-orcid":false,"given":"Maitreyee","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of DVL Hi \u2010 Tech Medical College &amp; 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