How to prepare a glycerin solution for atrophic rhinitis?

Glycerin Solution Preparation for Atrophic Rhinitis

For atrophic rhinitis, prepare a glucose-glycerin nasal solution by mixing equal parts sterile glucose solution with sterile glycerin to create glucose-glycerin nose drops, which serve as a moisturizing agent to combat nasal dryness and crusting. 1, 2

Standard Preparation Protocol

Basic Formulation

• Mix sterile glucose solution with sterile glycerin in equal proportions (1:1 ratio) to create the glucose-glycerin nose drops that are specifically mentioned as a treatment modality for atrophic rhinitis 1
• The glycerin concentration should be at least 20% if the solution contains less than 0.25% phenol, to maintain bacteriostatic properties 3
• Liquid paraffin can be used as an alternative moisturizing agent if glucose-glycerin is not available 1

Preparation Requirements

• Use aseptic technique throughout preparation: sanitize the preparation area with 70% isopropanol without added ingredients like dyes or glycerin 3
• Thoroughly wash hands to wrists with detergent or soap and potable water before compounding 3
• Sanitize necks of ampules and stoppers of vials with isopropanol before opening 3
• Prepare in a designated area where personnel traffic is restricted and contamination risks are minimized 3

Storage and Expiration

• Store prepared solutions at 4°C in a designated medication refrigerator (not used for food or specimens) 3
• Label with preparation date and expiration date (typically 3-12 months from preparation, but should not exceed the shortest expiration date of individual components) 3
• Discard any solution beyond its expiration date 3

Clinical Application Context

Role in Treatment Algorithm

• Glucose-glycerin nose drops are part of conservative management alongside regular nasal lavage with saline or sodium bicarbonate solution (2-3 times daily) as the foundation of atrophic rhinitis treatment 4, 5
• These moisturizing drops complement periodic debridement of crusts and help address the characteristic nasal dryness caused by atrophy of glandular cells 4, 5
• For purulent secretions, add antibiotics such as mupirocin to the lavage solution rather than to the glycerin drops 4, 5

Important Caveats

• The glucose-glycerin solution is a moisturizing adjunct, not a primary treatment—regular saline irrigation remains the mainstay 4, 5, 2
• No controlled trials exist evaluating specific therapies for atrophic rhinitis, and even observational data are limited 5
• Irrigation and debridement remain the standard treatment for atrophic rhinitis, with moisturizing drops serving as supportive care 2

When to Escalate Treatment

• If patients develop purulent secretions or acute infections despite conservative management, systemic antibiotics targeting Klebsiella ozaenae, Staphylococcus aureus, Proteus mirabilis, and E. coli are indicated 4, 5, 6
• Consider topical aminoglycosides (such as gentamicin) as an effective and cheaper alternative to intravenous aminoglycosides for persistent infections 6