Choosing Wisely internationally – helpful recommendations for antimicrobial stewardship!

Abstract

Purpose Antimicrobial resistance poses a major threat to human health globally and antibiotic overuse is a main driver of resistance. Antimicrobial stewardship (AMS) was developed to improve the rationale use of antibiotics. The Choosing Wisely campaign was initiated to ameliorate medical practice through avoidance of unnecessary diagnostic and therapeutic procedures. Our objective was to give an overview on the Choosing Wisely recommendations related to AMS practices from a selection of different countries in order to define future needs. Methods We evaluated the seven countries already analyzed for Choosing Wisely recommendations related to topics of infectious medicine before. Finally, we included five of the former countries (Australia/New Zealand, Canada, Italy, Switzerland, and USA) and Germany with easily accessible recommendations and selected those related to six categories of AMS as following: diagnostics, indication, choice of antiinfective drugs, dosing, application and duration of therapy. Results In total, 213 recommendations could be extracted related to AMS for the six countries and were matched to the chosen categories. Interestingly, no recommendations were found for the category “dosing.” Topics related to indication and diagnostics were most frequently found with 85 and 78 recommendations, respectively. Perioperative prophylaxis was a frequently addressed issue – both related to application, indication and duration. Avoiding antibiotic treatment of asymptomatic bacteriuria and upper respiratory tract infections were central topics of all countries. Conclusion AMS is an important strategy to fight increasing resistance and is frequently addressed by Choosing Wisely recommendations of different countries. Similar issues are considered important in the selected countries.

Assessment of Medical Test Overuse and Its Impact on Pediatric Emergency Department Outcomes in Upper Respiratory Tract Infections in a University Hospital in Lithuania

“…Interestingly, three urine cultures were obtained, and all of them were evaluated as normal or contaminated. Our findings indicated that age, gender, triage category, and duration of fever are not associated with the incidence of urinalysis, thus suggesting that urinalysis are performed against the guidelines and latest recommendations on urinary tract infection diagnostics [33][34][35].…”

Cystitis and Utipro® Plus: Real-World Evidence

“…Finally, in the case of probiotics, lactobacilli are thought to compete with uropathogens for vaginal epithelial adhesion receptors, leading to a prevention of colonization by uropathogenic organisms [ 21 ]. In addition, the increase in antibiotic resistance [ 22 ] and the role of non-antibiotic oral supplements in reducing UTI symptomatic episodes and the use of antibiotics are increasing the interest among physicians and researchers in the use of medical devices containing phytotherapy and nutraceutical compounds [ 9 , 10 , 11 ]. The current EAU Guidelines for urological infections state that the efficacy of herbal products such as cranberry products or herbal/plant extracts remains unclear, but clinicians can recommend their prescription in combination with antimicrobial therapies for the prevention of UTIs based on their favorable benefit-to-harm ratio [ 23 ].…”

Effectiveness Analysis of Clinical Pharmacists-Led Medication Therapy of Refined Management Mode:Antibiotics Administration

“…Health Commission of the People's Republic of China launched the National Action Plan based on the evaluation and summary of the work effect in the past few years, initiating the National Action Plan to Curb Antimicrobial Resistance (2022-2025) [12]. Antimicrobial stewardship (AMS) is an important strategy for the decrease of antimicrobial resistance and is widely used in antimicrobial management [13]. Clinical pharmacists are identi ed as key members of the AMS team [14].They participate in the whole process of antimicrobial use and management, and play a more prominent role.…”