Do you scale up 2nd generation anti-histamines to 4x daily in acute urticaria in the pediatric population as you do in adults?  

For kids experiencing moderate to severe urticaria that improve with single-dose antihistamine, do you scale up the manufacturer packaging dosages up to 4x daily dose as we do in adults? If not, it's been my experience that these kids will likely be treated with a short course of Prednisone after maxing out at a single daily dose of anti-histamine.