A tale of two fungi in a person with HIV.

The response by Dr. Philpot[1] is an interesting and useful response to my review of intranasal corticosteroids for the treatment of allergic rhinitis. The choice of criteria on which to base the review was selected to expand the criteria that are included in the prescribing information (PI), and therefore readily available to all physicians on the package insert. The practicing primary care physician is very interested in patient preference and cost-effectiveness as well as factors included in the PI, such as onset of action and safety. I appreciate the comments of Dr. Philpot in regard to the onset of action as described in the PI for each drug. The studies in the PI are useful and based on very strict criteria developed by the FDA [US Food and Drug Administration]. Other studies are allowed to develop difference time points for comparisons. Thank you for pointing out the differences in ages for which the drugs are approved for use. The comments for the table are very interesting and address issues that I chose not to include. The indications for nasal polyps, prophylactic use, and 3 types of rhinitis for fluticasone propionate are certainly true. This will become more important perhaps as we move primary care physicians to greater comfort and more common treatment of allergic rhinitis. Because the paper is titled as a review of allergic rhinitis, the indications for 3 types of rhinitis seemed less important. One of the major barriers that we have in primary care is moving from the bench and randomized controlled trial data reflected in the PIs into the translation of information that is useful to practicing physicians.[2] The areas chosen to review in this manuscript were an attempt to begin to address that translation. Sincerely, Readers are encouraged to respond to George Lundberg, MD, Editor of MedGenMed, for the editor's eye only or for possible publication via email: ten.epacsdem@grebdnulg