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It is not recommended to continue antibiotic therapy without evidence of need.
Choosing Wisely®
Society of Critical Care Medicine
In addition to employing microbe-directed therapy, a core principle of antibiotic stewardship is limiting antimicrobial therapy to the shortest effective duration. As a general rule, antimicrobials should be discontinued when the condition for which they were prescribed has been adequately treated, as one strategy to ensure access to effective antimicrobials, at a time when increased antimicrobial resistance represents a global health care challenge.
ver más ... 2021Do not repeat prenatal titrations for mothers with clinically significant antibodies (e.g. RhD, K) if prediction of fetal cognate antigen typing is feasible and is deemed to be negative.
Choosing Wisely Canada
Canadian Obstetrical and Pediatric Transfusion Network Canadian Society for Transfusion Medicine
Testing of a paternal sample and finding a negative antigen status (when paternity is assured) and/or non-invasive prenatal determination of the fetal genotype from maternal plasma with prediction of a negative antigen status confirm that the fetus is not at risk for hemolytic disease of the fetus and newborn and that ongoing pregnancy monitoring is unnecessary.
ver más ... 2021Use a 'universal precautions' approach for all psychoactive medications that have known potential or liability for abuse including opioids, benzodiazepines, antipsychotic medications, gabapentinoids, ...
Choosing Wisely Australia
Australasian Chapter of Addiction Medicine
The misuse of a prescription drug or drug class (e.g. benzodiazepines, opioids) is often followed by warnings to medical practitioners to avoid use of that medication or drug class. This may result in doctors using alternative psychoactive medications (e.g. quetiapine, pregabalin) which, in turn, become identified as ‘drugs of misuse’ and become ‘problem drugs’. Underlying this trend is an overreliance on medication in preference to psychosocial and physical therapies and a failure to ...
ver más ... 2021Do not perform serological weak D testing on antenatal samples with weak or variable RhD typing results.
Choosing Wisely Canada
Canadian Obstetrical and Pediatric Transfusion Network Canadian Society for Transfusion Medicine
Serologically weak reactions with Anti D antisera (≤ 2+) should be investigated with RHD genotyping. Pregnant mothers with weak or variable RhD typing and with pending genotyping results should be treated as RhD negative and should receive RhIg. Patients with genotyping confirming weak D type 1, 2 or 3 should be treated as RhD positive. Patients with other weak and variant RHD genotypes should be treated as RhD negative.
ver más ... 2021Do not routinely perform a group and screen test at the time of delivery unless there is no prior test during the current pregnancy and/or the risk of maternal hemorrhage or transfusion is high.
Choosing Wisely Canada
Canadian Obstetrical and Pediatric Transfusion Network Canadian Society for Transfusion Medicine
The likelihood of requirement for transfusion at the time of delivery is low. In a patient with a prenatal record confirming maternal ABO, Rh and a negative antibody screen provision of emergency uncrossmatched units is relatively safe when required on rare occasions. Routine pre delivery group and screen is not cost effective given the very low risk of transfusion with either vaginal delivery or routine Caesarean section. In the rare occasion that patients require a blood transfusion, O ...
ver más ... 2021