From the Guidelines
Treatment for postnasal drip is primarily focused on alleviating symptoms, with nasal corticosteroids being a recommended option.
Key Treatment Options
- Nasal corticosteroids: Effective in reducing total symptom score in adults suffering from acute post-viral rhinosinusitis, although the effect is small 1.
- Nasal irrigation with saline: May be beneficial, although the evidence is of very low quality 1.
- Decongestants: May be effective in improving mucociliary clearance, but there is a lack of clinically relevant data 1.
- Antibiotics: Not recommended for post-viral rhinosinusitis, as they have no benefit and may cause adverse events 1.
- Systemic corticosteroids: Not recommended due to potential harm and lack of significant benefits 1.
Specific Medications and Dosages
- Mometasone furoate nasal spray (MFNS): 200-400μg twice daily for 15-21 days, shown to reduce total symptom score and improve symptoms such as congestion and facial pain 1.
- Fluticasone propionate nasal spray (FPNS): 2 puffs twice daily for 21 days, shown to shorten time to clinical success and improve work performance 1.
Important Considerations
- Acute post-viral rhinosinusitis is a self-limiting disease, and treatment should focus on alleviating symptoms rather than curing the disease 1.
- Chronic rhinosinusitis may require different treatment approaches, including short-term antibiotics and systemic corticosteroids, although the evidence is limited 1.
From the Research
Treatment Options for Postnasal Drip
- Systemic medication, such as antibiotics, decongestants, and glucocorticoids, can be effective in treating postnasal drip syndrome, with a cure rate of 88% 2 and 94% 3.
- Improving the sticky film cilium function can also be beneficial in treating postnasal drip syndrome 2, 3.
- Treatment may also involve flushing the nasal cavity with herbal liquid, using glucocorticoid locally, taking medicine to improve the sticky film cilium function, immunotherapeutic, or operation, depending on the underlying cause of the postnasal drip syndrome 4.
- Empiric treatment for postnasal drip symptoms should be guided by associated symptoms that suggest either a sinonasal cause or gastroesophageal reflux 5.
- In some cases, surgical treatment may be required, such as for chronic sinusitis or nasal polyp 4, 6.
Factors Affecting Treatment Outcome
- The cause of postnasal drip syndrome can be complicated, and it is critical to check the cause and choose adaptable therapy for a good result 4.
- The effectiveness of treatment can vary depending on the underlying cause of the postnasal drip syndrome, with a total cure rate of 82% after 6 months follow-up in one study 4.
- Persistent, unexplainable, or severe symptoms may require referral to an otolaryngologist to rule out serious underlying conditions such as a mass lesion in the pharynx or a malignancy 5.