Multidisciplinary Delphi Consensus on the Clinical Use of Intranasal Carboxymethyl-β-Glucan-Resveratrol: Evidence-Based Recommendations for Upper Airway Diseases.

Background/Objectives: Intranasal carboxymethyl-β-glucan (CMBG)-resveratrol represents an innovative therapeutic approach for upper airway diseases, combining antimicrobial, anti-inflammatory, antioxidant, immunomodulatory, and antiallergic properties. Despite growing preclinical and clinical evidence, consensus on its clinical applications remains poorly defined. To establish evidence-based recommendations for the clinical use of intranasal CMBG-resveratrol through a multidisciplinary Delphi Consensus process. Methods: A two-round Delphi Consensus was conducted. In the first round, an expert board prepared, reviewed, and validated 22 statements based on current scientific evidence from preclinical and clinical studies. In the second round, 38 multidisciplinary experts evaluated each statement using a 5-point Likert scale (from 5 = strongly agree to 1 = strongly disagree). Consensus was defined as ≥80% agreement (scores 4 + 5). Results: All 22 statements achieved consensus (range: 83-100%). Strong agreement (≥90%) was reached for statements regarding the pathophysiological rationale (infection-inflammation-oxidative stress cycle), resveratrol's pleiotropic mechanisms of action, the role of CMBG in enhancing stability and bioavailability, and clinical efficacy in respiratory infections and allergic rhinitis. The mean scores ranged from 4.2 to 4.9, indicating high expert agreement across all domains. Conclusions: This multidisciplinary Delphi Consensus provides evidence-based recommendations for the use of intranasal CMBG-resveratrol to manage upper airway diseases, particularly respiratory infections and allergic rhinitis. The formulation's multitarget approach addresses the complex pathophysiology of these conditions through simultaneous antimicrobial (mainly antiviral), anti-inflammatory, and immunomodulatory effects.