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Introduction and purpose: Acute rhinosinusitis is a common condition worldwide, usually caused by respiratory viruses. Nasal epithelium is their primary point of entry and an active responder to the infection. Therefore, it seems reasonable for the treatment approach to include locally applied drugs. Our purpose is to bring forward up-to-date recommendations of intranasal treatment options for acute rhinosinusitis, and assess their efficacy and safety. Description of the state of knowledge: Rhinosinusitis is an inflammation of the mucosa present in the nose and the paranasal sinuses. It affects many patients yearly, bearing significant adverse effects on quality of life, productivity and healthcare expenditure. Acute rhinosinusitis lasts less than 12 weeks and is divided into viral, post-viral and acute bacterial rhinosinusitis. It is one of the prevailing reasons for unfounded antibiotics prescription, although it is usually self-limiting. Its treatment depends on the clinical stage of the infection, however, each of them encloses medications administered intranasally. Based on EPOS2020 and scientific publications it seems that nasal decongestants may be prescribed in viral rhinosinusitis, nasal corticosteroids in post-viral rhinosinusitis and nasal saline can prove beneficial in all clinical stages of rhinosinusitis. While used appropriately all aforementioned medications prove to be safe. Conclusions: In the light of the findings presented in this paper, it can be concluded that acute rhinosinusitis should be treated not only with oral, but also with intranasal drugs. Nasal decongestants are to be considered in viral rhinosinusitis mainly. Nasal corticosteroids show some positive effect in post-viral rhinosinusitis. Nasal saline can be administered in all clinical stages of acute rhinosinusitis. It is crucial to caution the patients against misuse of the medications, in order to prevent their adverse effects.

The increase of allergic rhinitis incidence is an actual problem for industrial cities. The literature data on allergic rhinitis incidence in countries of Europe andUkrainewas analyzed. According to different authors, the allergic rhinitis is registered in 12-24% of the inhabitants of the Russian Federation, 26-40% - of the USA, 24-32% - of France, 16% – of the UK, and 19% – of Denmark. There were distinguished three main clinical forms of allergic rhinitis: light, moderate and heavy. General pharmacotherapy principles of the light and moderate forms of allergic rhinitis course are presented in the current article. There were indicated medicines for the first-line therapy of allergic rhinitis group "R01AD" - the medicines acting on the respiratory system, decongestants and other drugs for topical use in diseases of the nasal cavity, corticosteroids. The assortment of nasal corticosteroids is presented by mometasone (13 trade names), beclamethasone (2 trade names), fluticasone propionate (5 trade names). It is also shown that 95.6% of the nasal corticosteroids is imported from 9 countries, mainly fromIndiaandBelgium. The Ukrainian spray Forinex produced by Pharmac is the only representative among the R01AD group, but unfortunately, according to pricing range is not a drug of choice among nasal corticosteroids. The received data testify to the risk of inclusion of only imported drugs in the insurance list and the low replacement rate by the Ukrainian drug for treatment of the allergic rhinitis.

Allergic rhinitis is one of the most common chronic diseases, affecting from 20 to 30% of adult population and 40% of children [8, 19]. In the past decades, the incidence of allergic rhinitis has been growing all over the world. 9% of the European population and 8.8 -16% of the U.S. population suffer from the pathology [1, 4]. Widespread comorbid conditions of allergic rhinitis which exacerbate the clinical pattern are asthma, sinusitis, otitis media [20, 24]. The disease is characterized by symptoms of different intensity which deteriorate the quality of life, everyday activity and productivity, even when treatment is quite effective [3, 14]. The main criteria in diagnosis of allergic rhinitis are medical history, clinical manifestations, positive skin tests and allergen-specific antibodies in blood serum.

Background: Antimicrobials treatment of Otitis media (OM) reduces some complications, but some of chronic complications, and specially otitis media with effusion (OME), seem to increase. Theoretically the usage of nasal corticosteroid sprays may prevent this problem by reducing the local inflammation around the eustachian tube. So, this study aimed to evaluate the role of nasal corticosteroid spray as an adjuvant for the treatment of OME. Methods: In a randomized, prospective clinical trial, 2 groups of 46 subjects who had OME were recruited. A questionnaire containing patients′ characters, history, complaints, otologic examinations, and the report of tympanometries was filled for all before and after treatment. We administered a period of amoxicillin and a decongestant for both group and nasal beclomethasone spray only for case group. Results: Thirty five of cases (76.1%) and 22 (47.8%) of controls had an improvement in their symptoms or the quality of hearing (p = 0.005). Partial remission was the most common finding in 52.2% of the patients in the case group but for control group there was no change (p = 0.024). The higher improvement in the tympanic retraction in the case group was significant (p < 0.05). A significant better tympanometric result has showed in the treatment of left ear in the patients of the case group (p = 0.038) but not for right ear (p = 0.136). Conclusions: We concluded that the administration of nasal beclomethasone spray as an adjuvant for the treatment of OME not only improved the results treatment but also increased the resolution of symptoms and the patients′ quality of hearing.

PurposeTo compare the profiles of the bronchodilator response (BDR) among children with asthma and/or allergic rhinitis (AR) and to determine whether BDR in these children is reduced by treatment with inhaled and/or nasal corticosteroid.MethodsSixty-eight children with asthma (mean age, 10.9 years), 45 children with comorbid asthma and AR (mean age, 10.5 years), and 44 children with AR alone (mean age, 10.2 years) were investigated. After a 2-week baseline period, all children were treated with inhaled fluticasone propionate (either 100 or 250 µg b.i.d., tailored to asthma severity) or nasal fluticasone propionate (one spray b.i.d. in each nostril) or both, according to the condition. Before and 2 weeks after starting treatment, all children were evaluated with spirometry and bronchodilator testing. BDR was calculated as a percent change from the forced expiratory volume in 1 second (FEV1) at baseline.ResultsThe mean BDR was 10.3% [95% confidence interval (CI) 8.3-12.4%] in children with asthma, 9.0% (95% CI 7.3-10.9%) in subjects with asthma and AR, and 5.0% (95% CI 4.1-5.9%) in children with AR alone (P

Objective: To test the antibacterial properties of three commercially available nasal corticosteroid preparations containing Mometasone Furoate (MF), Fluticasone Propionate (FP) and Fluticasone Furoate (FF) against S. pneumoniae, S. viridans, S. aureus, H. influenza, P. aeruginosa and E. coli. Methods: Study Design: Experimental in vitro study using the disc diffusion method. Clinical isolates of Streptococcus pneumoniae, Hemophilus influenzae, Streptococcus viridans, Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli were inoculated on separate plates. 0.15 ml of nasal corticosteroid preparations containing MF, FP and FF were applied to blank paper discs, then placed on the plates, including an empty disc. Following 24 and 48 hours of incubation, the inhibition zones were measured to the nearest mm from the point of abrupt inhibition of growth. Results: After 24 and 48 hours of incubation, S. pneumoniae, S. viridans, and S. aureus showed inhibition zones to all three preparations. S. aureus and S. viridans show the largest zones of inhibition at 24 and 48 hours respectively. H. influenza, P. aeruginosa and E. coli were negative. The inhibition zones of each bacteria were shown to be statistically different. The preparation containing FP had the largest zone of inhibition at 24 and 48 hours, although post hoc tests showed their difference was not significant. Conclusion: The present study demonstrates possible antimicrobial properties of commercially-available nasal corticosteroid preparations. However, it is unclear whether these can be attributed to the steroids, their excipients, or both. Further studies testing each component may offer better insights into their therapeutic use. Keywords: Mometasone Furoate, Fluticasone Propionate, Fluticasone Furoate, Antibacterial, Nasal Corticosteroids, Allergic Rhinitis, Acute Bacterial Rhinosinusitis