Terbinafine, 250 mg taken daily for 12 weeks, is the best regimen for toenail onychomycosis due to better clinical and mycologic cure rates, tolerability, and cost effectiveness (strength of recommendation [SOR]: A, meta-analyses)....

Though clinical preparticipation exams (PPE) are recommended by experts and required in most states, we found no medium- or better-quality evidence that demonstrates they reduce mortality or morbidity. PPEs detect only a very small percentage...

A canalith repositioning maneuver(CRM), such as the Epley or Semont maneuver, should be the first-line treatment for benign paroxysmal positional vertigo (BPPV) in the elderly (strength of recommendation [SOR]: A, several ...

Direct-to-consumer advertising (DTCA) is associated with both higher fidelity to minimum treatment recommendations for depression and higher prescribing levels of antidepressants for depression and adjustment disorder ...

reviews and randomized clinical trials with inconsistent and inconclusive results)...

With adults, oral theophylline may help lower the dosage of inhaled steroids needed to control chronic asthma. It offers no benefit for acute asthma exacerbations. For children, intravenous aminophylline may improve the clinical course of severe...

The inability of clinical criteria to accurately differentiate bacterial from viral disease makes routine use of antibiotics inappropriate for clinically diagnosed maxillary sinusitis (strength of recommendation [SOR]: C, based on inconsistent...

Routine screening of low-risk children for tuberculosis infection before entering kindergarten is not necessary. [Strength of recommendation: C] Targeted screening of high-risk children for tuberculosis infection using the ...

Vitamin C, when taken as a dietary supplement, does not appear to reduce mortality in patients with cardiovascular disease. [Strength of recommendation: B, based on reviews of cohort studies and a single randomized controlled ...

Frequent coughing is a concern for approximately 35% of those with typical gastroesophageal reflux disease (GERD) symptoms of heartburn and acid regurgitation as compared with 11% in those who do not have these symptoms. Among pulmonary clinic...

The best way to prevent recurrent bacterial vaginosis is to treat the initial episode with the most effective regimen. Metronidazole (500 mg orally twice daily for 7 days) has the lowest recurrence rate among antimicrobial ...

Clinical judgment remains the gold standard for hospital admission of infants with bronchiolitis, and it cannot be replaced by objective criteria (strength of recommendation [SOR]: B, based on prospective and retrospective cohort and retrospective...

When used to delay the progression of early nephropathy in patients with type 2 diabetes mellitus, angiotensin receptor blockers (ARBs) are not superior to angiotensin-converting enzyme (ACE) inhibitors. (Strength of ...

Several interventions may reduce the risk of contrast nephropathy for high-risk patients; however, most evidence uses surrogate markers for clinically relevant outcomes. Because dehydration is a risk factor for developing contrast nephropathy...

of clinical trials for meningococcal and Hib vaccines)....

Neuroimaging is warranted to evaluate headaches when patients present to an emergency department with signs or symptoms of an intracranial lesion. These signs or symptoms include abrupt onset of headache, focal neurological ...

(SOR: B, based on individual randomized controlled trial); pneumococcal vaccination of residents (SOR: B, based on randomized, nonblinded clinical trials and consistent case-control studies). Two other suggested interventions have not been extensively...

Jaw claudication, diplopia, or a temporal artery abnormality on physical exam increase the likelihood of temporal arteritis. A finding of thrombocytosis in a patient with suspected temporal arteritis moderately increases ...

No studies have addressed the question of whether metformin reduces development of diabetes among adolescents who are obese. Metformin treatment in adolescents who are obese can modestly reduce risk factors for type 2 ...

There is no clearly superior oral agent for glycemic control in patients with type 2 diabetes. (Strength of Recommendation [SOR]: C) Metformin (Glucophage) has shown additional benefit when compared with other treatments ...