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Don’t use antibiotics for upper respiratory infections that are likely viral in origin, such as influenza-like illness, or self-limiting, such as sinus infections of less than seven days of ...
Choosing Wisely Canada
College of Family Physicians of Canada
Bacterial infections of the respiratory tract, when they do occur, are generally a secondary problem caused by complications from viral infections such as influenza. While it is often difficult to distinguish bacterial from viral sinusitis, nearly all cases are viral. Though cases of bacterial sinusitis can benefit from antibiotics, evidence of such cases does not typically surface until after at least seven days of illness. Not only are antibiotics rarely indicated for upper respiratory ...
ver más ... 2018Don’t do imaging for lower-back pain unless red flags are present.
Choosing Wisely Canada
College of Family Physicians of Canada
Red flags include, but are not limited to, severe or progressive neurological deficits or when serious underlying conditions such as osteomyelitis are suspected. Imaging of the lower spine before six weeks does not improve outcomes.
ver más ... 2018Don’t use antibiotics in adults and children with uncomplicated acute otitis media.
Choosing Wisely Canada
Canadian Association of Emergency Physicians
Both adults and children commonly present to the emergency department with symptoms of a middle ear infection, or acute otitis media (AOM). The symptoms of AOM include fever, earache, discharge from ear, and/or decreased hearing. Evidence suggests that adults and children with uncomplicated AOM do not need antibiotics. Treatment should focus on analgesia and the use of antibiotics should be limited to complicated or severe cases. A watch and wait approach (analgesia and observation for 48 to 72 ...
ver más ... 2018Don’t order ankle and/or foot X-rays in patients who have a negative examination using the Ottawa ankle rules.
Choosing Wisely Canada
Canadian Association of Emergency Physicians
Foot and ankle injuries in children and adults are very common presentations to emergency departments. The Ottawa Ankle Rules (OAR) have been validated in both children (greater than 2 years old) and adult populations, and have been shown to reduce the number of X-rays performed without adversely affecting patient care. In alert, cooperative and sensate patients with blunt ankle and/or foot trauma within the previous ten days and who are not distracted by other injuries, only those who fulfill ...
ver más ... 2018Don’t routinely use antibiotics in adults and children with uncomplicated sore throats.
Choosing Wisely Canada
Canadian Association of Emergency Physicians
Adults and children frequently present to the emergency department with sore throats (pharyngitis). The vast majority of cases of pharyngitis are caused by self-limiting viral infections that do not respond to antibiotics. The benefit of antibiotics for the approximately 10% of cases in adults (25% in children), caused by bacteria (principally Group A Streptococcus (GAS)) is modest at best, although is associated with fewer complications and a slightly shorter course of illness. Inappropriate ...
ver más ... 2018