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The FDA has approved ensitrelvir (Xocova – Shionogi), a SARS-CoV-2 main protease inhibitor, for postexposure prophylaxis of COVID-19 in patients ≥12 years old who had contact with an infected individual. Ensitrelvir is the first oral antiviral drug to be approved in the US for this indication. The parenteral monoclonal antibody combinations bamlanivimab and etesevimab and casirivimab and imdevimab (REGEN-COV) are no longer authorized for postexposure prophylaxis of COVID-19 in the US.

Most respiratory tract infections are caused by viruses. Bacterial respiratory tract infections are usually treated empirically with antibiotic therapy that targets the most probable causative pathogens. Recommended antibiotic regimens for outpatient treatment of some common respiratory tract infections are listed in Table 1 for adults and Table 2 for children.

Differin Epiduo gel (Galderma), a fixed-dose combination of the synthetic retinoid adapalene 0.1% and the oxidizing agent benzoyl peroxide 2.5%, is now available over the counter (OTC) for topical treatment of acne in patients ≥12 years old. It will remain available by prescription for use in patients 9-11 years old. A gel containing adapalene 0.3% and benzoyl peroxide 2.5% (Epiduo Forte, and generics) is available by prescription for use in patients ≥12 years old.

The FDA now requires a warning about a risk of acute kidney injury in the product label for the 60-mg capsules of the pancreatic and gastric lipase inhibitor orlistat, which are available over the counter as Alli for weight loss.1 The label for the 120-mg capsules, which are available by prescription as Xenical, already includes a warning about a risk of oxalate nephrolithiasis and oxalate nephropathy (orlistat increases oxalate absorption).

Initial treatment of allergic rhinitis (AR) depends on the severity of symptoms and whether they are intermittent or persistent (see Table 1).

Influenza is generally a self-limited illness, but complications including pneumonia, respiratory failure, and death can occur, especially in persons at increased risk (see Table 1).

Excessive exposure to ultraviolet (UV) radiation can cause erythema, photoaging, and skin cancer. Sunscreens are widely used to reduce these risks, but questions remain about their effectiveness and safety. In 2021, the FDA proposed a rule that would require additional safety studies for some sunscreen active ingredients and mandate better UVA protection in sunscreen products.

The FDA has licensed new 2025-2026 formulations of the mRNA COVID-19 vaccines manufactured by Pfizer/BioNTech (Comirnaty) and Moderna (Spikevax, mNEXSPIKE) and the adjuvanted protein subunit COVID-19 vaccine manufactured by Novavax (Nuvaxovid). The new formulations are indicated for use in all adults ≥65 years old and in persons 6 months (Spikevax), 5 years (Comirnaty), or 12 years (mNEXSPIKE, Nuvaxovid) through 64 years old who are at high risk for severe COVID-19 because of an underlying condition. An Emergency Use Authorization allowing administration of the Pfizer vaccine to children 6 months through 4 years old has been withdrawn.

The Centers for Disease Control and Prevention (CDC) and the Environmental Protection Agency (EPA) recommend using insect repellents to prevent infections transmitted by mosquitoes and ticks. Insect repellents applied to exposed skin should be used in conjunction with other preventive measures such as wearing pants and long-sleeved shirts and avoiding outdoor activities during peak mosquito-biting times. Mosquitoes can transmit diseasecausing pathogens, including Zika, chikungunya, dengue, West Nile, eastern equine encephalitis, and yellow fever viruses, and the malaria parasite. Ticks can transmit the bacteria that cause Lyme disease, the rickettsia that cause Rocky Mountain spotted fever, and viruses such as Powassan virus. Some insect repellents containing EPA-registered active ingredients are listed in Table 1.

Adults with persistent fasting triglyceride levels ≥150 mg/dL are considered to have hypertriglyceridemia; when levels are ≥500 mg/dL, it is considered severe. Hypertriglyceridemia is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD); severe hypertriglyceridemia increases the risk of acute pancreatitis.