{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:49:26Z","timestamp":1787870966657,"version":"build-2784847793"},"reference-count":79,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/jcm15020678","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T15:12:04Z","timestamp":1768403524000},"page":"678","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Italian Evidence-Based Clinical Recommendations on the Appropriateness of Prescriptions and Diagnostic Tests in Pediatric Allergology: Focus on Anaphylaxis, Drug Allergy and Hymenoptera Venom Allergy"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4601-7484","authenticated-orcid":false,"given":"Valentina","family":"Fainardi","sequence":"first","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6525-2159","authenticated-orcid":false,"given":"Matteo","family":"Ricc\u00f2","sequence":"additional","affiliation":[{"name":"Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), AUSL-IRCCS Reggio Emilia, Forli, 47122 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachele","family":"Antignani","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana Medici Pediatri (SIMPE), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Bellodi","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana Medici Pediatri (SIMPE), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico Vito","family":"Buono","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Calvani","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Allergologia e Immunologia Pediatrica (SIAIP), Italy"},{"name":"UOC Pediatria, Ospedale S. Camillo-Forlanini, 00152 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Carbone","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6774-6152","authenticated-orcid":false,"given":"Fabio","family":"Cardinale","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Allergologia e Immunologia Pediatrica (SIAIP), Italy"},{"name":"UOC Pediatria, Ospedale Pediatrico \u201cGiovanni XXIII\u201d, 70126 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Chiappini","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive, Ospedale Meyer, 50139 Firenze, Italy"},{"name":"Societ\u00e0 Italiana di Pediatria Preventiva e Sociale (SIPPS), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Angiola","family":"Crivellaro","sequence":"additional","affiliation":[{"name":"UOSD Allergologia Azienda Ospedale, Universit\u00e0 di Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Cunico","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7880-3450","authenticated-orcid":false,"given":"Massimiliano","family":"Esposito","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Medicina Legale e delle Assicurazioni (SIMLA), Italy"},{"name":"Medicina Legale, Universit\u00e0 Degli Studi di Enna, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Licari","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Allergologia e Immunologia Pediatrica (SIAIP), Italy"},{"name":"UOC Clinica Pediatrica, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Miraglia Del Giudice","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Allergologia e Immunologia Pediatrica (SIAIP), Italy"},{"name":"Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Universit\u00e0 della Campania Luigi Vanvitelli, 80138 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Marsella","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana Gestori del Rischio in Sanit\u00e0 (SIGeRiS), Italy"},{"name":"UOC di Pediatria Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati di Avellino, 83100 Avellino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8552-0771","authenticated-orcid":false,"given":"Iria","family":"Neri","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Dermatologia Pediatrica (SIDeRP), Italy"},{"name":"UOC Clinica Dermatologica, IRCCS Azienda Ospedaliera Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4681-546X","authenticated-orcid":false,"given":"Rita","family":"Nocerino","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Pediatria Infermieristica (SIPINF), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0234-1373","authenticated-orcid":false,"given":"Diego","family":"Peroni","sequence":"additional","affiliation":[{"name":"Societ\u00e0 Italiana di Allergologia e Immunologia Pediatrica 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Field, M.J., and Lohr, K.N. 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