ABSTRACT:

Background: Allergic rhinitis and sinusitis are commonly encountered in primary practice, and nasal congestion is a common symptom experienced by these patients. Thus, it is important to address nasal congestion when treating these conditions. Despite the availability of several treatment options, therapy is impacted by adverse effects and patient dissatisfaction. We conducted a survey to evaluate the prescribing practices of physicians treating allergic rhinitis and sinusitis, with a focus on the formulation of topical xylometazoline with moisturizers (hypromellose and sorbitol).

Methods: We surveyed the prescribing practices of 545 Indian ear, nose and throat (ENT) physicians for rhinitis and sinusitis to understand the place of the formulation containing xylometazoline and moisturizer (sorbitol, hypromellose) in clinical practice. Towards this, physicians provided their response to a 10-item questionnaire covering prescribing practice and patient satisfaction.

Results: Overall, 91% of doctors reported that a decongestant along with a moisturizer would be beneficial to patients with nasal congestion due to allergic rhinitis and sinusitis, and a majority of doctors (89.5%) preferred prescribing xylometazoline with sorbitol and hypromellose. A majority of doctors reported high patient satisfaction with this formulation. Additionally, 78.35% of doctors reported high ratings for the reduction of nasal dryness.

Conclusion: The overall satisfaction of doctors and patients is high, indicating that this formulation is an ideal choice for achieving relief from nasal congestion due to AR and sinusitis.

KEYWORDS:

Allergic rhinitis; Rhino sinusitis; Xylometazoline; Hypromellose; Sorbitol

REFERENCES :

1) Chandrika D. Allergic rhinitis in India: an overview. Int J Otorhinolaryngol Head Neck Surg. 2017; 3(1): 1-6. https://www.ijorl.com/index.php/ijorl/article/view/185.
2) Khan AR, Siddiqui F. Regional prevalence of different types of sinusitis at a tertiary care centre in Northern India. Int J Otorhinolaryngol Head Neck Surg. 2020; 6(5): 969-73.

https://www.ijorl.com/index.php/ijorl/article/view/2200.
3) Storms W. Allergic rhinitis-induced nasal congestion: its impact on sleep quality. Prim Care Respir J. 2008; 17(1): 7-18. https://www.nature.com/articles/pcrj20081.
4) Shedden A. Impact of nasal congestion on quality of life and work productivity in allergic rhinitis. Findings from a large online survey. Treat Respir Med. 2005; 4(6): 439-46. https://link.springer.com/article/10.2165/00151829-200504060-00007.
5) Nathan RA. The pathophysiology, clinical impact, and management of nasal congestion in allergic rhinitis. Clin Ther. 2008; 30(4): 573-86.

https://www.sciencedirect.com/science/article/abs/pii/S0149291808001501.
6) Stewart M, Ferguson BJ, Fromer L. Epidemiology and burden of nasal congestion. Int J Gen Med. 2010; 3: 37-45.
7) Meltzer EO, Caballero F, Fromer LM, Krouse JH, Scadding G. Treatment of congestion in upper respiratory diseases. Int J Gen Med. 2010; 3: 69-91.

https://www.tandfonline.com/doi/full/10.2147/ijgm.s8184.
8) Werkhauser N, Bilstein A, Mahlstedt K, Sonnemann U. Observational study investigating Ectoin® Rhinitis Nasal Spray as natural treatment option of acute rhinosinusitis compared to treatment with Xylometazoline. Eur Arch Otorhinolaryngol.
2022; 279(3): 1371-81. https://link.springer.com/article/10.1007/s00405-021-06916-0.
9) Eccles R, Eriksson M, Garreffa S, Chen SC. The nasal decongestant effect of xylometazoline in the common cold. Am J Rhinol. 2008; 22(5): 491-6.

https://journals.sagepub.com/doi/abs/10.2500/ajr.2008.22.3202.
10) Wade A, Weller P. Handbook of Pharmaceutical Excipients. 2nd ed. Washington and London: American Pharmaceutical Agent and The Pharmaceutical Press; 1994.
11) Mallol J, Nogues MR. Evaluation of the moisturizing properties of Otrivin Moisturizing nasal spray. A comparative study with Otrivin nasal drops. GSK Internal Report. (via CSS Otrivin Xylometazoline 2019 resource).
12) Trevino RJ. Air pollution and its effect on the upper respiratory tract and on allergic rhinosinusitis. Otolaryngol Head Neck Surg. 1996; 114(2): 239-41.

https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/abs/10.1016/S0194-59989670174-2.
13) Siddique S, Ray MR, Lahiri T. Effects of air pollution on the respiratory health of children: a study in the capital city of India. Air Qual Atmos Health. 2011; 4(2): 95-102. https://link.springer.com/article/10.1007/s11869-010-0079-2.
14) Eccles R, Martensson K, Chen SC. Effects of intranasal xylometazoline, alone or in combination with ipratropium, in patients with common cold. Curr Med Res Opin. 2010; 26(4): 889-99. https://www.tandfonline.com/doi/abs/10.1185/03007991003648015.
15) Canonica GW, Mullol J, Pradalier A, Didier A. Patient perceptions of allergic rhinitis and quality of life. Findings from a survey conducted in Europe and the United States. World Allergy Organ J. 2008; 1(9): 138-144.
https://www.worldallergyorganizationjournal.org/article/S1939-4551(19)30592-7/fulltext.