Rational Allergy Practice Guidelines by the Indian Academy of Pediatrics (IAP) and IAP-Allergy and Applied Immunology Chapter.

objectivesRecognition of allergic diseases in children is on the rise globally, with a similar burden in lower-middle-income countries such as India. There is a lack of structured, context-specific guidelines and standardized care pathways for pediatric allergic diseases. This document aims to provide evidence-based, pragmatic guidance for rational allergy practice in children. JUSTIFICATION: Heterogeneous diagnostic approaches and non-uniform management practices for allergic conditions in children contribute to inaccurate disease burden estimation, inappropriate investigations, and suboptimal therapeutic outcomes, thereby increasing morbidity and healthcare costs. PROCESS: Key domains including asthma, allergic rhinitis, atopic dermatitis, food allergy, urticaria/angioedema, and anaphylaxis were identified. A multidisciplinary expert panel comprising pediatricians, pulmonologists, otorhinolaryngologists, clinical immunologists, internists, and allergists was constituted, with inputs from World Allergy Organization (WAO) Centers of Excellence and professional bodies. Systematic literature searches were conducted in Cochrane Library, Medline, Embase, and Google Scholar. Evidence was appraised and graded using established classification systems. Feasibility, equity, and resource implications relevant to India were considered, with provisions for periodic updates. RECOMMENDATIONS: These guidelines provide an evidence-based framework for rational diagnosis, judicious testing, standardized treatment, timely referral, patient and family education, rational allergen immunotherapy, and advocacy for training and policy development. They aim to standardize pediatric allergy care in India while supporting, not replacing, clinician judgment.