Onychomycosis is caused most commonly by Trichophyton rubrum or T. mentagrophytes. About 10% of all persons worldwide and 40% of those ≥60 years old are believed to have the disease. Risk factors include older age, diabetes, poor peripheral circulation, smoking, HIV infection, psoriasis, and immunosuppression. Left untreated, onychomycosis can cause nail plate destruction, ingrown nails, and (particularly in patients with diabetes) secondary infections. Guidelines on treatment of onychomycosis have been published.

The FDA has expanded its Emergency Use Authorization (EUA) for the COVID-19 vaccine manufactured by Pfizer/BioNTech (Comirnaty) to permit use of the bivalent formulation (containing mRNA from the original and BA.4/5 Omicron strains of SARS-CoV-2) as a booster dose in children 6 months to 4 years old who completed the primary series with 3 doses of the monovalent formulation ≥2 months previously. The Pfizer bivalent vaccine had previously been authorized for use as a booster dose in persons ≥5 years old and as a third primary dose in children 6 months to 4 years old. Booster...

In the recent Medical Letter article on Drugs for Chronic Heart Failure (2025: 67:81), the paragraph on adverse effects of SGLT2 inhibitors should have stated that these drugs can cause ketoacidosis, which can be fatal, especially in patients with type 1 diabetes.

View the Table: Over the Counter At-Home Tests for COVID-19

View the Comparison Chart: Some Drugs for Irritable Bowel Syndrome with Constipation (IBS-C)

The FDA has expanded its Emergency Use Authorization for the adjuvanted protein subunit COVID-19 vaccine manufactured by Novavax to include its use as a first booster dose in adults who completed a primary series with any COVID-19 vaccine ≥6 months previously and are unable or unwilling to receive a booster dose of a bivalent mRNA vaccine. The Novavax vaccine is not authorized for use in persons who have received a booster dose of any other COVID-19 vaccine.

View the Comparison Chart: Safety of Drugs for IBS in Pregnancy and Lactation

Zusduri (UroGen), a mitomycin-based solution for intravesical instillation, has been approved by the FDA for treatment of recurrent low-grade intermediate-risk nonmuscle invasive bladder cancer (NMIBC) in adults. It is the first drug to be approved in the US for this indication. Mitomycin has been available for years for treatment of various malignancies.

The Interruption of Anticoagulation section of our article on Treatment of Atrial Fibrillation cited the recommendations of the American College of Chest Physicians on perioperative management of antithrombotic therapy (JD Douketis et al. Chest 2022; 162:e207). A reader suggested that our general statement on when to discontinue an oral anticoagulant would have benefited from inclusion of the recommendations of the American College of Cardiology/American Heart Association (JA Joglar et al. Circulation 2024; 149:e1). Recommendations for periprocedural management of oral anticoagulant therapy...

The FDA has approved lutetium lu 177 vipivotide tetraxetan (Pluvicto – Novartis) for treatment of prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC) in adults previously treated with androgen receptor (AR) pathway inhibitors and taxane-based chemotherapy.