The Journal of family practice
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Review
Clinical inquiries. When should you suspect community-acquired MRSA? How should you treat it?
There are no clinical or epidemiologic features that will help you to clearly distinguish community-acquired methicillin-resistant Staphylococcus aureus infections (CA-MRSA) from methicillin-sensitive (CA-MSSA) infections. Incision and drainage is the primary therapy for purulent skin and soft tissue infections. There are inadequate data evaluating the role of oral antibiotics for MRSA.
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Behavioral measures, such as weight loss, altered sleeping position, and avoidance of alcohol and sedatives, can benefit some patients with mild obstructive sleep apnea (OSA). The mainstay of therapy for OSA is administration of continuous positive airway pressure (CPAP). Oral appliances may benefit patients who are unable or unwilling to use CPAP or other forms of PAP therapy. The wakefulness-promoting agent modafinil is recommended for patients who experience residual sleepiness despite optimal CPAP therapy, provided CPAP compliance is closely monitored.
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Stop prescribing antibiotics for adults with a clinical diagnosis of acute sinusitis, unless the patient has severe symptoms. Antibiotics have little if any positive effects on the severity and duration of symptoms, and they cause adverse effects and create unnecessary expense.