Amber Luong, MD, PhD, associate professor in the department of otorhinolaryngology at The University of Texas Medical School at Houston, who was not involved with the guideline’s creation, found these specific recommendations to be particularly noteworthy. “In straightforward cases, you should empirically treat for AR with an oral antihistamine or possibly a nasal steroid spray,” she said. “Don’t order confirmatory tests unless the patient fails empirical therapy.”
And, while it can be tempting to order a computed tomography (CT) scan, Dr. Luong said the recommendations state that it is not necessary in patients with a clear history of AR. “As a physician, it’s important to remember that a lot of AR symptoms overlap with sinus disease, but a CT scan is not warranted unless the patient doesn’t respond as expected to treatment,” she added. “Then it’s time to explore alternative diagnoses.”
Environmental Controls
The panel recommended that physicians advise that AR patients who have identified allergens that correlate with clinical symptoms avoid known allergens or possibly utilize environmental controls (e.g., remove pets and use air filtration systems, bed covers, and acaricides). The guideline includes a discussion of the literature’s findings.
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