ENT (Ear, Nose, Throat) + Cough/cold

Pages we plan to refresh

• Sinusitis: this is one of our highest-priority ENT updates. We plan to rebuild the page around the 2025 AAO-HNS adult sinusitis update, current acute bacterial rhinosinusitis diagnostic criteria, watchful waiting where appropriate, antibiotic stewardship, penicillin-allergy considerations, chronic-rhinosinusitis evaluation, and current surgical/biologic pathways.
• Pharyngitis: we plan to update group A streptococcal testing and treatment, Centor/McIsaac-style decision support, viral features that make testing unnecessary, current gonococcal treatment, antibiotic-allergy pathways, and antimicrobial stewardship.
• Otitis Media: we plan to update diagnostic criteria, observation versus immediate antibiotics, age-specific treatment, recurrent disease, tympanostomy considerations and the relationship to the current pediatric guideline framework.
• Otic Preparations / Otitis Externa: we plan to re-check currently marketed products, topical antibiotic/steroid combinations, tympanic-membrane perforation considerations, ototoxicity risk, fungal disease, analgesia, and when systemic antibiotics are or are not appropriate.
• Antitussives / Expectorants: we plan to rebuild this table around current product availability, evidence for symptomatic benefit, benzonatate safety, duplicate-ingredient risk, and current age restrictions for prescription opioid cough/cold products.
• Decongestants: we plan to update pseudoephedrine, topical sympathomimetics, hypertension/cardiovascular precautions, rebound congestion, and the FDA’s continuing regulatory process involving oral phenylephrine after concluding the orally administered ingredient is not effective as a nasal decongestant.
• Antihistamines: we plan to better distinguish first-generation sedating/anticholinergic agents from second-generation options, highlight geriatric and CNS-burden considerations, and update renal/hepatic dosing where relevant.
• Nasal Preparations: we plan to update intranasal corticosteroids, intranasal antihistamines, combination sprays, saline therapy, anticholinergic options, current product availability, administration technique and safety.
• Leukotriene Inhibitors / Allergic Rhinitis: we plan to make the montelukast boxed warning and FDA recommendation to reserve its allergic-rhinitis use for patients who do not respond to or cannot tolerate alternatives much more prominent.
• Cerumen: we plan to build a more practical guideline-based pathway covering diagnosis, cerumenolytics, irrigation, manual removal, contraindications, hearing-aid users and referral considerations.
• Hearing-loss resources: we plan to add stronger age-related hearing-loss pathways, OTC hearing-aid context, audiology referral, ototoxic-medication review, cochlear-implant referral and urgent evaluation for sudden sensorineural hearing loss.
• Tinnitus: we plan to create a dedicated clinical page separating benign chronic tinnitus from pulsatile, unilateral, neurologic or sudden-hearing-loss presentations that warrant more urgent evaluation.
• Cough / cold: we plan to improve duplicate-ingredient warnings, pediatric safety, duration-of-cough guidance, red flags and the distinction between symptom relief and treatment of the underlying cause.
• Mouth / lip and sore-throat preparations: we plan to verify current products, anesthetic and antiseptic ingredients, age restrictions, local adverse effects and when persistent oral/pharyngeal symptoms require diagnostic evaluation rather than continued OTC therapy.
• New ENT decision-support tools: we plan to evaluate whether dedicated GlobalRPh tools for sore-throat testing, sudden hearing loss, allergic rhinitis, rhinosinusitis and ototoxicity would add meaningful clinical value before adding calculators simply to fill the section.