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Choosing Wisely®

American Academy of Otolaryngology, Head and Neck Surgery Foundation

Oral antibiotics may have significant adverse effects and do not provide demonstrable benefit after tonsillectomy. Avoidance of oral antibiotics can reduce the spread of antibiotic resistance and the risk of opportunistic infections.

Prescrire bilan. Towards better patient care: drugs to avoid

Prescire International

Glyceryl trinitrate 0.4% ointment has no proven efficacy beyond the placebo effect in healing chronic anal fissures or alleviating the pain they cause. Headache is a very common adverse effect, and can be severe.

Prescrire bilan. Towards better patient care: drugs to avoid

Prescire International

Prucalopride is authorised for chronic constipation but shows only modest efficacy, and only in about one in six patients. Its adverse effect profile is poorly documented, particularly with respect to cardiovascular disorders (palpitations, ischaemic cardiovascular events, possible QT prolongation), depression and suicidal ideation, and teratogenicity.

Prescrire bilan. Towards better patient care: drugs to avoid

Prescrire International

Nifuroxazide, an intestinal “anti-infective” agent with no proven efficacy in diarrhoea, can provoke serious immunological reactions.

Prescrire bilan. Towards better patient care: drugs to avoid

Prescire International

The neuroleptics domperidone, droperidol and metopimazine can provoke arrhythmias and sudden death. These adverse effects are unacceptable given the symptoms they are used to treat (nausea and vomiting, and gastroesophageal reflux in the case of domperidone) and their weak efficacy.