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Antibiotics not the answer to allergies

The first clinical practice guidelines on treating the common cold and allergic rhinitis by the Health Ministry spell out when antibiotics should be given as treatment.
The Straits Times - April 12, 2013
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Antibiotics not the answer to allergies

The first clinical practice guidelines on treating the common cold and allergic rhinitis by the Health Ministry spell out when antibiotics should be given as treatment.

Doctors should not start antibiotics or antibacterial medication for the common cold, which is a viral infection, unless symptoms worsen or persist beyond 10 days.

This is to reduce the rapid emergence of antibiotic resistance, which is becoming a global problem, said Clinical Associate Professor Siow Jin Keat. The senior consultant at the department of otorhinolaryngology at Tan Tock Seng Hospital led the workgroup which drew up the guidelines.

If antibiotics are used indiscriminately, it results in the bacteria developing immunity against them.

Prof Siow said patients should not ask to have antibiotics for a cold, or "doctor hop" to get them.

The guidelines, which were published in February 2010, include an online guide for patients.

Prof Siow said the guidelines seek to clarify for doctors and patients the differences between the common cold (known medically as acute viral rhinosinusitis) and allergic rhinitis.

The common cold is a condition which affects children frequently and adults about twice a year. It lasts about a week.

Allergic rhinitis, which affects about 30 per cent of the population, is perennial and may last for many years. Patients often think they have a perpetual cold.

Both the common cold and allergic rhinitis have similar symptoms of an itchy and runny nose, sneezing and a blocked nose.

But their treatment is different. The treatment for the common cold is supportive. It includes rest and the use of nose drops to clear the nasal blockage and short-term antihistamines, which ease inflammation.

The treatment for allergic rhinitis includes identifying and avoiding the allergen, the use of intra-nasal steroids and long-term antihistamines, both of which relieve inflammation.

Prof Siow said the guidelines are timely, because of a rising incidence of allergic rhinitis and asthma in urban societies, a trend which has been noted by epidemiologists in the past 30years.

This has an impact on Singapore, which has a highly developed urban environment, said Prof Siow.

He said that a 1991 report showed that allergic rhinitis in the United States was more prevalent in children growing up in states with greater urban environments such as New York, compared with those who grew up in states with more rural environments, such as Iowa.

Studies in Finland and India support this finding, he said.

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