Annual vaccination against influenza A and B viruses is recommended in the US for everyone ≥6 months old without a contraindication. Influenza vaccines available in the US for the 2025-2026 season are listed in Table 2.

Bacterial infections in adults are generally treated empirically, with the antibiotic covering most, but not all, of the potential causative pathogens. For some infections, culture and sensitivity testing can guide treatment, allowing for use of narrower-spectrum antibiotics. The recommended dosages and durations of antibiotic treatment for common respiratory, skin, and urinary tract infections are listed in Tables 1-3. Infectious disease experts now recommend shorter treatment durations for many infections to reduce the development of antimicrobial resistance and minimize adverse...

Rheumatoid arthritis (RA) is prevalent in 0.5% of adults in the US; it is about 2.5 times more common in women than in men. Guidelines for treatment of RA from the American College of Rheumatology were recently updated. The goal of treatment is to minimize disease activity and prevent irreversible joint damage.

Gastroesophageal reflux disease (GERD) is the most common GI condition encountered in the outpatient setting; it affects about 20% of people in the US.

Opioid use disorder is a chronic, relapsing disease with physical and psychiatric components. It is associated with economic hardship, social isolation, incarceration, increased rates of blood-borne infections such as HIV and viral hepatitis, adverse pregnancy outcomes, and increased mortality. According to the NIH, there were 80,411 deaths involving an opioid in the US in 2021, more than in any previous year. Several guidelines on the management of opioid use disorder are available; all recommend maintenance pharmacotherapy as the standard of care.

Mild to moderate plaque psoriasis can be treated with topical drugs and phototherapy. Patients with moderate to severe disease generally require systemic therapy. Guidelines for the treatment of psoriasis with topical therapy, phototherapy, and systemic drugs have recently been published.

Overweight is generally defined as a body mass index (BMI) between 25 and 29.9 kg/m2 in adults. A BMI ≥30 is considered obese (criteria differ slightly in Asian patients). In patients with an elevated BMI, a 5-10% reduction in weight has been associated with a reduction in the risk of developing type 2 diabetes, hypertension, and dyslipidemia. Diet, exercise, and behavior modification are the traditional methods for losing weight, but they are often inadequate; the American College of Cardiology no longer recommends that all patients try lifestyle modification alone before adding...

Recently, full-page advertisements have appeared in the New York Times and other newspapers promoting the Viralizer (Viral Response Systems, Greenwich, CT), a heated nebulizer-sprayer device marketed for treatment of colds, sore throats, allergy and sinusitis symptoms. The device is available without a prescription for about $30 to $40.

Isosorbide mononitrate (ISMN; Ismo - Wyeth-Ayerst), an oral nitrate long available in Europe, was recently approved by the US Food and Drug Administration for prophylactic use in patients with chronic stable angina. ISMN is the major active metabolite of isosorbide dinitrate (ISDN; Isordil, and others).

Desflurane (Suprane - Anaquest), an inhalation anesthetic, has been approved by the US Food and Drug Administration for induction and maintenance of general anesthesia in adults and for maintenance of anesthesia in infants and children. Like isoflurane (Forane), the last volatile anesthetic to become available in the USA (Medical Letter, 23:112, 1981), the new agent is a halogenated methyl ethyl ether, differing from isoflurane in the substitution of a fluorine for a chlorine atom.