Allergic rhinitis: managing the pediatric spectrum.

Allergic rhinitis (AR) is the most common chronic disease in the pediatric population and its prevalence is increasing. AR can significantly impact a child's health. It causes uncomfortable symptoms, impairs quality of life, and can predispose to the development of comorbidities such as asthma. Although allergen avoidance is the first step in AR management, it often is impractical. Fortunately, there are a number of pharmacologic agents available for the treatment of AR. When choosing a medication, attention should be paid to the substance's risk/benefit ratio. First-line therapy consists of second-generation antihistamines, which lack many of the unwanted side effects caused by first-generation compounds, and intranasal corticosteroids, which are the preferred agents for children with persistent symptoms. Other pharmacologic options include decongestants, leukotriene-receptor antagonists, and intranasal cromolyn sodium. Allergen immunotherapy can be a valuable adjunctive modality. Issues of compliance and convenience also are important considerations.