The "Choosing Wisely" initiative in infectious diseases

Area of Science:

• Infectious Diseases
• Internal Medicine
• Public Health

Background:

• The international "Choosing Wisely" campaign promotes evidence-based medical practices.
• It aims to reduce unnecessary procedures and improve patient safety.
• The German Society of Infectious Diseases (DGI) participates to address overuse and underuse in infectious disease management.

Purpose of the Study:

• To develop a list of

Main Methods:

• Committee members of the DGI identified potential "Choosing Wisely" items.
• Topics underwent systematic evidence review.
• The top ten items were selected, with five positive and five negative recommendations approved by member vote.

Main Results:

• Recommendations cover Staphylococcus aureus bloodstream infections, antibiotic use in critically ill patients, influenza and measles vaccination.
• Guidelines address oral antimicrobial preference, avoiding antibiotics for uncomplicated upper respiratory infections and asymptomatic bacteriuria.
• Specific recommendations include not treating Candida in respiratory/GI specimens, limiting prophylactic antibiotic duration, and avoiding antibiotics for elevated CRP/procalcitonin without infection signs.

Conclusions:

• Implementing these "Choosing Wisely" recommendations can reduce patient harm.
• These guidelines enhance the value of healthcare delivery in infectious diseases.