Allergy and immunology practice parameters and guidelines

It's spring break, and you're seeing a college student who has a history of moderate-to-severe spring and summer rhinoconjunctivitis. Skin testing shows remarkable wheal and flare reactions to tree and grass pollens. In addition to recommending aeroallergen avoidance measures, which initial treatment has the highest likelihood of helping this patient: intranasal corticosteroid monotherapy or intranasal corticosteroid combined with intranasal antihistamine? Previous practice parameters tended to outline treatments with good evidence of effectiveness, but they rarely provided specific recommendations for these types of questions.

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