Treatment Options for the Child with Allergic Rhinitis

Abstract

Allergic rhinitis is extremely common in pediatric populations. Its symptoms can interfere markedly with everyday life; moreover, untreated allergic rhinitis can predispose patients toward more serious respiratory diseases. Therapy focuses both on reducing the causes (avoidance, immunotherapy) and on controlling manifest symptoms (pharmacotherapy). Antihistamines, decongestants, anticholinergic agents, mast cell stabilizers, and intranasal corticosteroids constitute the pharmacotherapy arsenal. Of these, the intranasal corticosteroids most effectively control the major symptoms; many studies have found that their efficacy in persistent allergic rhinitis is greater than that of decongestants, antihistamines, and cromolyn sodium. Moreover, unlike systemic corticosteroids, they are generally free from adverse side effects. Thus, with appropriate attention to education and formulations most tolerable to children, they should be a wise choice for many pediatric patients.