An International Journal Clinical Rhinology

Register      Login

VOLUME 10 , ISSUE 3 ( 2017 ) > List of Articles

RESEARCH ARTICLE

Assessment of Clinical Effectiveness of Various Drugs in the Patients of Allergic Rhinitis visiting Tertiary Care Hospital of Punjab, India

Gurpreet Kaur, Rachna Dhingra, Manjinder Singh

Keywords : Allergic rhinitis, Chlorpheniramine, Desloratadine, Fexofenadine, Levocetirizine, Montelukast

Citation Information : Kaur G, Dhingra R, Singh M. Assessment of Clinical Effectiveness of Various Drugs in the Patients of Allergic Rhinitis visiting Tertiary Care Hospital of Punjab, India. Clin Rhinol An Int J 2017; 10 (3):132-136.

DOI: 10.5005/jp-journals-10013-1324

License: CC BY-ND 3.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Introduction: Allergic rhinitis is characterized by mild to severe upper respiratory symptoms, such as nasal congestion, rhinorrhea, sneezing, and itching. In this study, attempt is being made to evaluate the clinical efficacy of various drugs in allergic rhinitis and to compare clinical efficacy in individual symptom score of allergic rhinitis. Materials and methods: Totally, 125 patients clinically diagnosed as suffering from allergic rhinitis were enrolled for the study. All the patients were randomly divided into five groups of 25 each. Patients were given tablet Montelukast 10 mg once a day (OD) in group I, tablet Levocetirizine 5 mg OD in group II, tablet Fexofenadine 180 mg OD in group III, tablet Desloratadine 5 mg OD in group IV, and tablet Chlorpheniramine maleate 4 mg three times a day (TDS) in group V. Each patient was followed up after 2 weeks and then after 4 and 6 weeks for the sneezing and nasal congestion/obstruction. Results: At the 2nd week follow-up, Levocetirizine was significantly effective with 40% patients having zero (0) sneezing symptom score and with mean rank 45.54 as compared with other drugs. At fourth and 6th week follow-up, Montelukast was more effective with 48 and 56% patients having zero sneezing symptom score and having mean rank 54.60 and 51.78 as compared with other drugs. At 2nd week follow-up, Levocetirizine was significantly effective with 24% patients having zero symptom score; at 4th week follow-up, Montelukast was more effective with 44% patients having zero symptom score in nasal discharge; and at 6th week follow-up, Montelukast was more effective with 60% patients having zero symptom score. Conclusion: Symptomatic improvement was seen in all the drug groups. It was observed that Levocetirizine was better at 2 weeks. Overall, at the end of 6 weeks of treatment, Montelukast group had maximum improvement followed by Levocetirizine, Fexofenadine, Desloratadine, and Chlorpheniramine respectively.


PDF Share
  1. Singh-Franco D, Ghin HL, Robles GI, Borja-Hart N, Alexandra P. Levocetirizine for the treatment of allergic rhinitis and chronic idiopathic urticaria in adults and children. Clin Ther 2009 Aug;31(8):1664-1687.
  2. May, JR.; Smith, PH. Allergic rhinitis. In: Dipiro JT, Talbert RL Yee GC, Matzke GR, Wells BG, Posey ML, editors. Pharmacotherapy. A pathophysiologic approach. 7th ed. New York (NY): McGraw Hill; 2008. p. 1565-1575.
  3. Mullol J. Positioning of antihistamines in the allergic rhinitis and its impact on asthma (ARIA) guidelines. Clin Exp Allergy Rev 2012 Mar;12(1):17-26.
  4. Okubo K, Baba K. Therapeutic effect of montelukast, a cysteinyl leukotriene receptor 1 antagonist, on Japanese patients with seasonal allergic rhinitis. Allergol Int 2008 Sep;57(3): 247-255.
  5. Cingi C, Gunhan K, Gage-White L, Unlu H. Efficacy of leukotriene antagonists as concomitant therapy in allergic rhinitis. Laryngoscope 2010 Sep;120(9):1718-1723.
  6. Durham, S. Management update in rhinitis and nasal polyposis. Lisbon, Portugal. March 24-25, 1995.
  7. Pawankar R. Allergic rhinitis and asthma from the link to emerging therapies. Indian J Chest Dis Allied Sci 2003 Jul- Sep;45(3):179-189.
  8. Sibbald B, Rink E. Epidemiology of seasonal and perennial rhinitis clinical presentation and medical history. Thorax 1991 Dec;46(12):895-901.
  9. Mygind, N. Nasal allergy. Oxford: Blackwell Scientific Publications; 1978. p. 52-84.
  10. Jones NS, Carney AS, Davis A. Prevalence of allergic rhinosinusitis: a review. J Otol Laryngol 1998 Nov;112(11):1019-1030.
  11. Price DB, Scadding G, Bachert C, Saleh H, Nasser S, Carter V, von Ziegenweidt J, Durieux AM, Ryan D. UK prescribing practices as proxy markers of unmet need in allergic rhinitis: a retrospective observational study. NPJ Prim Care Respir Med 2016 Jun;26:16033.
  12. Ramírez-Jiménez F, Pavón-Romero G, Juárez-Martínez LL, Terán LM. Allergic rhinitis. J Aller Ther 2012 May;S5:006.
  13. Choe KS, Sclafani AP, Litner JA, Yu GP, Romo T 3rd. The Korean American woman's face: anthropometric measurements and quantitative analysis of facial aesthetics. Arch Facial Plast Surg 2004 Jul-Aug;6(4):244-252.
  14. Perkins S, Patel A. Endonasal suture techniques in tip rhinoplasty. Facial Plast Surg Clin North Am 2009 Feb;17(1):41-54.
  15. Toriumi DM. Structure approach in rhinoplasty. Facial Plast Surg Clin North Am 2002 Feb;10(1):1-22.
  16. Dobratz EJ, Tran V, Hilger PA. Comparison of techniques used to support the nasal tip and their long-term effects on tip position. Arch Facial Plast Surg 2010 May-Jun;12(3):172-179.
  17. Friedman O, Koch CA, Smith WR. Functional support of the nasal tip. Facial Plast Surg 2012 Apr;28(2):225-230.
  18. Mohebbi A, Jahandideh H, Faham Z, Jafari M. Defining the best nasal tip projection among Iranian women. Plast Surg Int 2016;2016:8549276.
  19. Bhattacharyya N. Bacterial infection in chronic rhinosinusitis: a controlled paired analysis. Am J Rhinol 2005 Nov- Dec;19(6):544-548.
  20. Boase S, Foreman A, Cleland E, Tan L, Melton-Kroft R, Pant H, Hu FZ, Ehrlich GD, Wormald PJ. The microbiome of chronic rhinosinusitis: culture, molecular diagnostics and biofilm detection. BMC Infect Dis 2013 May;13:210.
  21. Mantovani K, Bisanha AA, Demarco RC, Tamashiro E, Martinez R, Anselmo-Lima WT. Maxillary sinuses microbiology from patients with chronic rhinosinusitis. Braz J Otorhinolaryngol 2010 Sep-Oct;76(5):548-551.
  22. Brook I, Gober AE. Recovery of potential pathogens in the nasopharynx of healthy and otitis media-prone children and their smoking and nonsmoking parents. Ann Otol Rhinol Laryngol 2008 Oct;117(10):727-730.
  23. Wu J, Peters BA, Dominianni C, Zhang Y, Pei Z, Yang L, Ma Y, Purdue MP, Jacobs EJ, Gapstur SM, et al. Cigarette smoking and the oral microbiome in a large study of American adults. ISME J 2016 Mar;10(10):2435-2446.
  24. Ertel A, Eng R, Smith SM. The differential effect of cigarette smoke on the growth of bacteria found in humans. Chest 1991 Sep;100(3):628-630.
  25. Reh DD, Higgins TS, Smith TL. Impact of tobacco smoke on chronic rhinosinusitis: a review of the literature. Int Forum Allergy Rhinol 2012 Sep-Oct;2(5):362-369.
  26. Lee KI, Kim DW, Kim EH, Kim JH, Samivel R, Kwon JE, Ahn JC, Chung YJ, Mo JH. Cigarette smoke promotes eosinophilic inflammation, airway remodeling, and nasal polyps in a murine polyp model. Am J Rhinol Allergy 2014 May-Jun;28(3):208-214.
  27. Kumar PS, Matthews CR, Joshi V, de Jager M, Aspiras M. Tobacco smoking affects bacterial acquisition and colonization in oral biofilms. Infect Immun 2011 Nov;79(11): 4730-4738.
  28. Namiot Z, Namiot DB, Kemona A, Gołebiewska M, Bucki R. The effect of cigarette smoking and alcohol consumption on efficacy of Helicobacter pylori eradication. Pol Arch Med Wewn 2000 Sep;104(3):569-574.
  29. Linder JA, Sim I. Antibiotic treatment of acute bronchitis in smokers: a systematic review. J Gen Intern Med 2002 Mar;17(3):230-234.
  30. Lee WK, Ramanathan M Jr, Spannhake EW, Lane AP. The cigarette smoke component acrolein inhibits expression of the innate immune components IL-8 and human betadefensin 2 by sinonasal epithelial cells. Am J Rhinol 2007 Nov-Dec;21(6):658-663.
  31. Kamath PM, Shenoy VS, Mittal N, Sharma NK. Microbiological analysis of paranasal sinuses in chronic sinusitis—a south Indian coastal study. Egypt J Ear Nose Throat All Sci 2013 Nov;14(3):185-189.
  32. Bezerra TF, Pádna FG, Ogawa AI, Gebrim EM, Saldiva PH, Voegels RL. Biofilms in chronic rhinosinusitis with nasal polyps: pilot study. Braz J Otorhinolaryngol 2009 Nov- Dec;75(6):788-793.
  33. Hashemi M, Sadeghi MMM, Omrani MR, Torabi MA. Microbiology and antimicrobial resistance in chronic resistant rhino sinusitis with or without polyp after functional endoscopic sinus surgery. J Res Med Sci 2005;10(3):167-171.
  34. Farahani F, Youse Mashouf R, Hashemian F, Esmaeili R. Antimicrobial resistance patterns of aerobic organisms in patients with chronic rhinosinusitis in Hamadan, Iran. Avicenna J Clin Microb Infec 2014 Aug;1(2):e18961..
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.