Symptomatic treatment of symptoms in children

The picture of itching, sneezing and profuse rhinorrhoea is typical of early allergic rhinitis, but nasal obstruction becomes more prominent over time, especially in perennial allergic rhinitis. This gives rise to the classic facial appearance of children with perennial allergic rhinitis and to the many complications. The most effective therapy for allergic rhino-sinusitis involves topical nasal steroids. What to do for the child with yet another upper respiratory tract infection is a common practice dilemma. Unfortunately, upper respiratory tract infections are commonly mismanaged, particularly by the use of antibiotics for viral disease. Of similar concern is the use of oral corticosteroids, often together with antihistamines, for both viral infections and allergic disease. There is a definite place for both antibiotics and corticosteroids in upper respiratory tract disease, but these indications are limited to clearly defined conditions. Unnecessary antibiotic usage can be reduced by careful medical and patient education.1,2