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A new practice guideline (Physician's First Watch Feb 3 2015) advocates the empiric use of nasal steroids as first-line therapy for allergic rhinitis in children aged 2 years and older. Inhaled corticosteroids have been associated with decreases in linear growth, but conflicting results and study design weaknesses led the FDA to publish guidelines for pediatric clinical trials evaluating inhaled corticosteroids and growth. In an industry-supported study conforming to these FDA guidelines, researchers randomized 299 normally growing children (age range, 3 to 9 years) with skin test–positive perennial allergic rhinitis and active symptoms to receive triamcinolone acetonide aqueous nasal spray (Nasacort; one 55-µg spray in each nostril daily) …