Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines—2024–2025 Revision: Part II—Guidelines on Oral and Ocular Treatments
The guideline compares major medication classes, including oral antihistamines (OAHs), leukotriene receptor antagonists (LTRA), and ocular therapies, to guide optimal treatment selection. Overall, OAHs are preferred over LTRA, and intranasal corticosteroids (from prior guidance) remain superior first-line therapy, with limited benefit in combining LTRA with antihistamines. Ocular antihistamines and mast cell stabilizers are appropriate for eye symptoms, though systemic therapies are generally favored for broader control. Clinical implications: Clinicians should prioritize intranasal steroids and second-generation oral antihistamines, avoid routine LTRA add-on therapy, and individualize treatment based on symptom profile, patient preferences, and cost to improve adherence and outcomes. Full Access: European Journal of Allergy
Commonly Prescribed Drugs as Risk Factors for Clostridioides difficile Infections: A Swedish Population-based Case–control Study
This study found that antibiotics with the greatest CDI risk were lincosamides, penicillin combinations, sulfonamides, trimethoprim, and cephalosporins, though no association was found with tetracyclines. Among non-antibiotic drugs, we found decreased risks of CDI for lipid-modifiers and aspirin and increased risks for antidiarrheals, corticosteroids, proton-pump inhibitors (PPIs), nervous system drugs, constipation drugs, histamine H2-receptor antagonists, antidepressants, and beta blockers, but no significant risk for non-steroidal anti-inflammatory drugs. Clinical implications: The article highlights prudent prescribing decisions and antimicrobial stewardship. Also, PPI as a main risk factor for CDI and showed new evidence for other non-antibiotic drugs as potentially important risk factors considering their high prescription prevalence. Full Access: BMJ
Stopping the Flow: Tranexamic Acid as an Adjunct to Anterior Epistaxis Management – An Invited Commentary
This article reviews the role of topical tranexamic acid (TXA) as an emerging adjunct in the management of anterior epistaxis, a common urgent care visit, traditionally treated with pressure, vasoconstrictors, cautery, or nasal packing. Evidence from randomized trials and meta-analyses suggests that topical TXA achieves faster hemostasis and reduces rebleeding rates compared with standard nasal packing. It also shortens emergency department length of stay and improves patient comfort by avoiding painful packing and removal procedures. Benefits appear particularly relevant in patients on antiplatelet or anticoagulant therapy, where bleeding control is often more challenging. Clinical implications: these findings support integrating topical TXA into epistaxis protocols as a safe, effective, and less invasive first-line or adjunct therapy, potentially reducing resource utilization and follow-up visits while maintaining high efficacy. Full Access: American Journal of Otolaryngology
Role Of Migraine in Recurrent Benign Paroxysmal Positional Vertigo
This retrospective cohort study of patients with benign paroxysmal positional vertigo (BPPV) assessed whether migraine, thyroid disease, and environmental factors predict recurrence. Over a follow-up period, recurrence occurred in 20.1% of patients, and multivariate analysis demonstrated that migraine was the only significant independent predictor of recurrence. Clinical implication: This supports migraine evaluation and targeted management strategies, especially in patients with BPPV. Full Access: Journal of Otolaryngology