Internal Medicine Guidelines for Clinicians

A curated, quarterly-updated list of the guidelines most relevant to our practice. Last updated: October 2026. Next scheduled update: January 2027.

Geriatric Prescribing

2023 AGS Beers Criteria® — American Geriatrics Society
Potentially inappropriate medications in adults 65+. Notable: avoid warfarin as initial therapy for nonvalvular AF or VTE where DOACs are preferred, avoid aspirin for primary prevention, and avoid sulfonylureas, with expanded drug–disease and drug–drug interaction guidance and deprescribing advice.
Source: https://www.aafp.org/afp/2023/1100/poems-inappropriate-medication-use

Cardiology / Cardiometabolic

2025 AHA/ACC Guideline for High Blood Pressure in Adults
Replaces the 2017 guideline. Treatment goal <130/80 mmHg for most adults; uses the AHA PREVENT™ risk calculator; early treatment to reduce cognitive decline and dementia risk.
Source: https://www.acc.org/About-ACC/Press-Releases/2025/08/13/20/03/New-high-blood-pressure-guideline-emphasizes-prevention-early-treatment-to-reduce-CVD-risk

2026 AHA/ACC/ADA/ASN Guideline for Cardiovascular-Kidney-Metabolic (CKM) Syndrome
First guideline treating obesity, type 2 diabetes, CKD, and CVD as one interconnected syndrome, in five progressive stages.

2026 ACC/AHA Dyslipidemia Guideline (update)
For high-risk secondary prevention, LDL-C goal <55 mg/dL; measure Lp(a) at least once in everyone.

ADA Standards of Care in Diabetes — 2026
Expanded GLP-1–based therapy chosen by cardiorenal risk; stronger SGLT2i/GLP-1 positioning in heart failure and ASCVD.

Perioperative Care

2026 AHA/ACC Perioperative Cardiovascular Management Guideline for Noncardiac Surgery (reaffirmation of the 2024 guideline)
Stepwise assessment with RCRI or NSQIP risk tools; stress testing only in highly selected patients; stop SGLT2 inhibitors 3–4 days before planned surgery. The 2026 reaffirmation made no changes to the 2024 recommendations.
Source: http://www.acc.org/latest-in-cardiology/ten-points-to-remember/2024/09/23/04/15/2024-aha-acc-perioperative-guideline-gl

Pulmonary

GOLD 2026 Report — COPD
Dual LABA/LAMA is now the default initial therapy for symptomatic COPD; Group E = anyone with ≥1 moderate or severe exacerbation in the prior year; RSV vaccine recommended from age 50.

Infectious Disease

IDSA 2026 Guidance on Antimicrobial-Resistant Gram-Negative Infections
Full refresh covering ESBL-E, AmpC-E, CRE, difficult-to-treat Pseudomonas, CRAB, and Stenotrophomonas; piperacillin-tazobactam now an alternative for ESBL-E UTIs.

IDSA Guidelines on Complicated Urinary Tract Infections
Any catheter-associated or bacteremic UTI is now "complicated"; 7-day total course for improving bacteremic complicated UTI instead of 14 days.

Palliative Care / Hospice

Specialty Palliative Care Scope Guidelines (Mount Sinai task force, 2026)
Prioritize serious illness defined by both high mortality risk and significant impact on quality of life or caregiver burden.

FY 2026 CMS Hospice Final Rule (effective October 1, 2025)
Hospice face-to-face attestation for third and later recertifications must be explicitly signed and dated; a signed, dated clinical note can serve as the attestation itself.