New guidelines for the prevention and treatment of gout have been issued by the American College of Rheumatology. For prevention, allopurinol or febuxostat are first line (alternative is probenecid if these are contraindicated), which should be maximized for a goal serum urate levels <6 mg/dL. For treatment of acute gouty arthritis, monotherapy with steroids, NSAIDs, or colchicine are recommended. Full guidelines are available at (ACR site)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.