Allergic Rhinitis ACG – Diagnosis and management

Published on 15 May 2026

This ACE Clinical Guideline (ACG) provides evidence-based recommendations on the diagnosis and management of perennial allergic rhinitis. Specifically, guidance is provided on the diagnostic criteria for AR, clinical indications for allergy testing, considerations when selecting pharmacological therapy, and use of allergen avoidance strategies..

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Allergic rhinitis – diagnosis and management (May 2026) [PDF]

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ACG recommendations

1. Diagnose allergic rhinitis based on the patient’s history, particularly their symptoms, combined with a physical examination.

2. Conduct allergy testing only when clinically warranted, for example when diagnosis is unclear, or when optimised pharmacotherapy provides inadequate symptom control.

3. Prescribe intranasal corticosteroid, oral antihistamine (2nd generation or later), or combination intranasal corticosteroid and intranasal antihistamine to manage allergic rhinitis.

4. Offer allergen avoidance advice to all patients with allergic rhinitis as an adjunct to pharmacological therapy, focusing on accessible and practical strategies.

ACG references and Expert Group details

Allergic rhinitis – diagnosis and management references (May 2026) [PDF]

Allergic rhinitis ACG EG composition and other details (May 2026) [PDF]

ACG EtR framework

The Evidence-to-Recommendation (EtR) framework is a document that outlines the underpinning evidence and rationale for the recommendations in our ACGs. Download the EtR framework below to learn more about factors that have informed the strength of the ACG recommendations, including certainty of evidence, clinical benefit/risk balance, local resource implications, feasibility considerations, patient preferences and values, acceptability and other considerations.

Allergic Rhinitis ACG EtR framework with summary of findings (May 2026) [PDF]