Voriconazole (Vfend -- Pfizer), an antifungal triazole structurally related to fluconazole (Diflucan) with a spectrum of action similar to that of itraconazole, has been approved by the FDA for primary treatment of invasive aspergillosis and for refractory infection with Scedosporium apiospermum (the asexual form of Pseudallescheria boydii) or Fusarium spp.

The most common cause of travelers' diarrhea, usually a self-limited illness without fever lasting several days, is infection with noninvasive enterotoxigenic (ETEC) or enteroaggregative (EAEC) strains of Escherichia coli. Campylobacter, Shigella, Salmonella, Aeromonas, viruses and parasites are less common.

The FDA has approved oritavancin (Orbactiv – The Medicines Company), a long-acting lipoglycopeptide antibiotic given as a single intravenous (IV) dose, for treatment of acute bacterial skin and skin structure infections caused by susceptible gram-positive bacteria in adults. It is the third lipoglycopeptide antibiotic to be marketed in the US; telavancin (Vibativ) and dalbavancin (Dalvance) were approved earlier.

Olodaterol (Striverdi Respimat – Boehringer Ingelheim), a new inhaled long-acting beta2-agonist, has been approved by the FDA for once-daily maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD). It is not approved for treatment of acute exacerbations of COPD or for treatment of asthma. Olodaterol is the third long-acting beta2-agonist to be approved by the FDA for once-daily use; indacaterol (Arcapta Neohaler), which is available as a single agent, and vilanterol, which is available only in fixed-dose combinations with the...

Many patients ask their physicians whether they should take vitamins. Since the last Medical Letter article on this subject, more data have become available on the benefits and risks of taking vitamin supplements.

Percutaneous coronary intervention (PCI), such as balloon angioplasty or stent placement, predisposes to subsequent thrombosis. The current pharmacologic approach to prevention of this problem combines an anticoagulant with one or more antiplatelet drugs.

Terazosin (Hytrin - Abbott), a postsynaptic alpha 1 -adrenoreceptor blocker previ-ously available for treatment of hypertension (Medical Letter, 29:113, 1987), has now been approved by the US Food and Drug Administration (FDA) for treatment of benign prostatic hyperplasia (BPH). Although not previously approved by the FDA, terazosin and other alpha-blockers such as prazosin (Minipress, and others) or doxazosin (Car-dura) have been used for this indication for many years.

Recombinant human deoxyribonuclease I (rhDNase; dornase alfa; Pulmozyme - Genentech), an enzyme that hydrolyzes extracellular DNA, is now available as a purified solution to decrease the viscosity of sputum in patients with cystic fibrosis. It requires a nebulizer to produce an aerosol mist for inhalation.

The FDA has approved a new formulation of fluoxetine for once-weekly maintenance treatment of depression in patients who have responded to daily fluoxetine (Prozac).

The FDA has approved the marketing of an extended-release formulation of trazodone (Oleptro – Angelini Labopharm) for treatment of major depressive disorder in adults. Immediate-release trazodone has been available for treatment of depression for many years, but is used mostly in low doses for its sedating effects.