The "Choosing Wisely": initiative in infectious diseases

"Choosing Wisely" is a growing international campaign aiming on practice changes to improve patient health through avoidance of unnecessary diagnostic and therapeutic procedures. Our objective was to give an overview on recommendations related to diagnostic and therapeutic issues in infectious diseases from the "Top Five" lists of different medical societies and countries.

11 countries featuring specific interest in "Choosing Wisely" met in 2014 to learn from each other about their specific campaigns. These countries were checked for released "Top Five" lists and subsequently screened for issues related to infectious diseases (ID). Recommendations containing the terms "infection", "antibiotics", "antimicrobials", "antifungals", "antivirals", "vaccination", "resistance" and "cultures" were defined as related to ID.

In 7 out of 11 countries "Top Five" lists have been released. Topics of infectious diseases were related to treatment, diagnostics and prevention and present in 51 out of 628 recommendations (8 %) in all countries except Japan. Notably, unnecessary use of antibiotics in upper respiratory tract infections and asymptomatic bacteriuria were cited by several societies from different countries.

Several societies include topics referring to ID in their recommendations which reflect the high relevance for this field with the overuse of antibiotics as the major concern.