Abstract
BACKGROUND: Allergic rhinitis and urticaria are chronic persistent allergic conditions that need proper management as they significantly reduce quality of life measures. Of the many pharmacological options of allergic rhinitis and urticaria, second-generation antihistamines are the mainstay of therapy. AIMS: This review focuses on the knowledge of medical residents toward prescribing antihistamines, according to the new ARIA and GA2LEN guidelines for allergic rhinitis and urticaria, attempting to find the cause of less prescription of newer second-generation antihistamines by finding out the knowledge and attitude of the doctors prescribing them to the patients. MATERIALS AND METHODS: The study was carried out among resident doctors at a tertiary care teaching hospital. Primary data from 100 resident doctors, who gave their informed consent, was collected. A prevalidated questionnaire regarding knowledge, attitude and prescribing practice of antihistamines was filled up. The data was then analyzed with suitable statistical tests. Every question was first validated using the Chi-square test, and significance was below 10% hence proving validity of the questions. RESULTS: Out of the doctors surveyed, 82% of doctors said they prescribed second-generation antihistamines, while 18% still prescribed first-generation antihistamines. Out of the 82% that prescribed second-generation antihistamines, 8.9% also prescribed first-generation antihistamines as well. 23% of doctors surveyed had heard about the ARIA and GAL2EN guidelines and their recommendations for prescribing second-generation antihistamines over the older first-generation antihistamines, while 77% of them had not heard of these position papers. CONCLUSION: First-generation or classic antihistamines are still overused due to the lack of knowledge of various guidelines that have been published. The main reason for not prescribing the second-generation antihistamines was due to the increased cost per tablet compared to the more economical first-generation antihistamines.