Pediatric Allergic Rhinitis Guidelines

Updated: Nov 15, 2017
  • Author: Jack M Becker, MD; Chief Editor: Harumi Jyonouchi, MD  more...
  • Print
Guidelines

Guidelines Summary

Joint Task Force on Practice Parameters (JTFPP)

In 2017, the Joint Task Force on Practice Parameters (JTFPP) released updated recommendations for the treatment of seasonal allergic rhinitis (SAR) in adolescents and adults. [16]

Updated guidelines include the following:

  • In patients aged 12 years or older, nasal symptoms of SAR should be treated at least initially with an intranasal corticosteroid (INCS) alone rather than an INCS–oral antihistamine combination.
  • In patients aged 15 years or older, moderate to severe SAR should be treated with an INCS over a leukotriene receptor antagonist (LTRA).
  • Clinicians may recommend combination therapy with an INCS and an intranasal antihistamine (INAH) over either agent alone.

American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNS)

In 2015, the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNS) released guidelines for treating patients ages 2 and up who suffer from allergic rhinitis. [17]

Key recommendations include the following:

  • For patients with a stuffy nose, nasal passage discoloration, and/or red and watery eyes, doctors should forgo sinus imaging process in favor of specific immunoglobulin E screening. Sinonasal imaging exposes patients to unnecessary radiation.
  • Intranasal steroids and oral antihistamines are recommended as first lines of treatment. Oral leukotriene receptor antagonists are not.
  • Sublingual or subcutaneous immunotherapy should be offered to patients who do not respond to pharmacologic therapy.