7 for 11: Updates in pediatric anaphylaxis

Historically, one of the biggest barriers to understanding and diagnosing anaphylaxis has been a lack of consensus definition and clinical tools to support the standardization of anaphylaxis recognition and management. This review details important updates to the field on the subject of pediatric anaphylaxis in the past year. In 2025, a new consensus definition and clinical tool for anaphylaxis was published by an international expert panel with endorsement from 46 international, multidisciplinary medical and patient advocacy organizations. There have also been important changes to management of pediatric anaphylaxis, including the introduction of a new commercially available intranasal form of epinephrine and updated allergy action plans that incorporates a new "watchful waiting" approach and descriptions of age-specific symptoms and additional accessibility considerations to accommodate individuals with color-blindness and of different reading levels. In all cases, the action plan advises shared decision-making with the patient and their caregivers. In addition, primary care providers are proposed to have a more active role within interdisciplinary teams at school and daycare settings in management of pediatric anaphylaxis. As the definition of anaphylaxis continues to evolve, the clinical community faces an ongoing challenge to incorporate these refinements into practice. Health care providers and patients alike need accessible, reliable tools to help recognize and manage anaphylaxis. Continued efforts are also needed to ensure that validated clinical support tools and standardized action plans can be effectively integrated into real-world care.