The Infectious Diseases Society of America (IDSA) has issued a list of five tests or treatments that physicians and patients should question. This is a part of the Choosing Wisely campaign, an initiative intended to advance medical professionalism in clinical practice.

The list was created by IDSA’s Quality Improvement Committee after identifying a preliminary list of inappropriate and overused clinical practices.

RELATED: Emergency Docs Issue Additional Choosing Wisely Recommendations

  1. Don’t treat asymptomatic bacteruria with antibiotics: Overtreatment with antibiotics can lead to C. difficile infection and also to the emergence of resistant pathogens, on top of being costly. Some exceptions to this recommendation include pregnant patients, patients undergoing urological surgery, or those who have received a kidney or kidney pancreas transplant (within the first year of receiving the transplant).
  2. Avoid prescribing antibiotics for upper respiratory infections (URIs): Proven infections such as Strep throat and pertussis should be treated with antibiotics, however, since the majority of URIs are viral in etiology, prescribing antibiotics would be both ineffective and potentially harmful in these cases.
  3. Don’t use antibiotic therapy for stasis dermatitis of lower extremities: Standard of care treatment for stasis dermatitis of the lower extremities is a combination of leg elevation and compression. Routine antibiotic use does not improve healing rates and may actually result in unnecessary hospitalization and potential harm to the patient.
  4. Avoid testing for a Clostridium difficile infection in the absence of diarrhea: Unless ileus due to C. difficile is suspected, testing should be performed only on diarrheal stool.
  5. Avoid prophylactic antibiotics for the treatment of mitral valve prolapse: The risk of antibiotic side effects outweigh the benefit from prophylactic antibiotic therapy; prophylaxis therapy is no longer indicated for prevention of infective endocarditis in patients with mitral valve prolapse.

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