Clinical Practice Guideline for Physicians on Allergic Rhinitis

Abstract

Recently, the rhinitis work group of the Korean Academy of Asthma, Allergy and Clinical Immunology developed a practice guideline on allergic rhinitis. The group consisted of physicians, pediatricians, and otolaryngologists. Here, the guideline is adapted for clarity and for ease of use by physicians. To manage allergic rhinitis well, accurate diagnosis is most important. In patients with rhinitis symptoms, the first step is to perform a skin prick test to inhalant allergens, and/or to measure allergen-specific immunoglobulin E in serum. Next, allergic rhinitis should be diagnosed upon documenting the association between positive allergens and rhinitis symptoms, via patient history or allergen nasal provocation test. Allergic rhinitis should be differentiated from non-allergic rhinitis, because treatment modalities differ between the two. Allergic rhinitis should be effectively managed with allergen avoidance, pharmacotherapy, allergen immunotherapy, surgical treatment, and/or saline irrigation. Second-generation antihistamines or leukotriene modifiers may be used for mild-to-moderate forms, and intranasal steroids may be effective for moderate-to-severe forms. Allergic rhinitis is closely associated with asthma. Spirometry should be performed initially for asthma diagnosis, if asthma-like symptoms are present. (Korean J Med 2017;92:429-436)