Treatment of Acute Urticaria in Children (Age Under 18 Years)

Acute urticaria in the pediatric population requires careful treatment selection. Agent choice must account for the child's weight and age, and safety in children is a primary consideration that shapes which therapies are appropriate first-line.

Clinical scenario Acute urticaria presenting in a child or adolescent under 18 years of age. The patient population requires age- and weight-appropriate therapy; options that carry a less favourable safety profile in children are excluded from first-line use.

Treatment approach (partial) First-line treatment centres on a weight- and age-adjusted 2nd generation H1-antihistamine with established efficacy and safety in the pediatric population. First-generation H1-antihistamines are not recommended as first-line in children. The specific agents and complete dosing guidance are in the full protocol.

Treatment goal Complete symptom control — full absence of wheals and pruritus — with a consistently achieved urticaria activity score of zero (UAS = 0).

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/all.70210

1st generation H1-antihistamines have an inferior safety profile compared with 2nd generation H1-antihistamines, and are, therefore, not recommended as first line treatment in children with urticaria.

Second-generation H1-antihistamines with proven efficacy and safety in the pediatric population include bilastine, cetirizine, desloratadine, fexofenadine, levocetirizine, loratadine, and rupatadine.

We recommend aiming at complete symptom control in urticaria, considering as much as possible the safety and the quality of life of each individual patient.

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