Abstract: Although the overall incidence of drug allergy in children is lower than that in adults，its impact on prescribing decisions，antimicrobial strategies and healthcare costs is substantial.Standardized diagnosis is key to improving medication safety and avoiding unnecessary drug avoidance.This commentary reviews mechanisms of drug hypersensitivity and speciality of pediatric hypersensitivity，proposes a practicable，stratified diagnostic pathway，and outlines diagnostic pathway points for common “allergic” drugs in children，including β-lactam antibiotics，NSAIDs，and vaccines.In light of China’s current context，we highlight system bottlenecks and propose targeted solutions to strengthen diagnostic capacity in drug allergy and improve medication safety in children.

Key words: drug hypersensitivity reactions, child, diagnosis and treatment

摘要： 儿童药物过敏总体发生率虽低于成人，但对处方决策、抗菌策略与医疗成本的影响不容忽视。规范化诊断是提升用药安全、减少不必要药物回避的关键。该文评述药物超敏反应的机制及儿童药物超敏反应的特殊性，提出可执行的分层化诊疗路径，并就儿科常见“过敏”药物，包括β- 内酰胺类抗生素、非甾体抗炎药与疫苗，给出诊断路径要点，同时结合中国实际，指出当前瓶颈并提出改进方向，旨在提升儿童药物过敏诊断能力，提升儿童用药的安全性。

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