New clinical practice guideline for treatment of seasonal allergic rhinitis SAR has been published November 7 2017 in Annals of Allergy Asthma and Immunology. The guidelines recommend that For initial treatment of SAR in adults clinicians should routinely prescribe monotherapy with an intranasal corticosteroid ICS rather than ICS in combination with an oral antihistamine. For initial treatment of SAR in adults clinicians should recommend an ICS over a leukotriene receptor antagonist. For treatment of moderate to severe SAR in adults clinicians may recommend the combination of an INCS and an intranasal antihistamine for initial treatment.