Update on the "Choosing Wisely" initiative in infectious diseases in Germany.

Draenert R, Jung N, Addo M, Berner R, Bickel M, Bogner JR, Cornely OA, De With K, Faetkenheuer G, Hagel S, Hanses F, Harrer T, Hartmann P, Herold S, Hippenstiel S, Kern W, Klauke S, Klinker H, Lehmann C, Lemmen S, Lübbert C, Pletz MW, Rieg S, Ruf BR, Rupp J, Salzberger B, Slevogt H, Stellbrink HJ, Stephan C, Suttorp N, Ullmann A, Witzenrath M, Witzke O (2020)

Publication Language: English

Publication Type: Journal article, Review article

Publication year: 2020

Journal

Book Volume: 48

Pages Range: 317-321

Journal Issue: 3

DOI: 10.1007/s15010-020-01400-z

Abstract

PURPOSE: The Choosing Wisely® initiative is an international campaign addressing over- and underuse of diagnostic and therapeutic measures in infectious diseases among others. Since 2016, the German Society for Infectious Diseases (DGI) has constantly designed new items in this regard. Here we report the most recent recommendations. METHODS: The recommendations of the DGI are part of the "Klug entscheiden" initiative of the German Society of Internal Medicine (DGIM). Topics for the new items were suggested by members of the DGI, checked for scientific evidence and consented within the DGI and the DGIM before publication. RESULTS: The new recommendations are: (1) individuals with immune-suppression, advanced liver cirrhosis or renal insufficiency should receive a dual pneumococcal vaccination. (2) In case of positive blood cultures with Candida spp. thorough diagnostics and treatment should be initiated. (3) In case of suspected meningitis, adult patients should receive dexamethasone and antibiotics immediately after venipuncture for blood cultures and before potential imaging. (4) In case of suspected meningitis a CT scan before lumbar puncture should not be ordered-except for symptoms indicating high CSF pressure or focal brain pathology or in cases of severe immune-suppression. (5) In patients with suspected severe infections, a minimum of two pairs of blood cultures should be drawn using separate venipunctures prior to antibiotic therapy-regardless of body temperature. There is no need of a minimum time interval in between the blood draws. CONCLUSION: Applying these new Choosing Wisely® recommendations will increase patient safety and the value of health care.

Authors with CRIS profile

Involved external institutions

Ludwig-Maximilians-Universität (LMU) Germany (DE) Universität zu Köln Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Technische Universität Dresden Germany (DE) Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen Germany (DE) Friedrich-Schiller-Universität Jena Germany (DE) Julius-Maximilians-Universität Würzburg Germany (DE) Goethe-Universität Frankfurt am Main Germany (DE) Albert-Ludwigs-Universität Freiburg Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Universität Duisburg-Essen (UDE) Germany (DE) Universitätsklinikum Leipzig Germany (DE) Universität zu Lübeck Germany (DE) Universitätsklinikum Regensburg Germany (DE) Klinikum St. Georg Germany (DE) Universitätsklinikum Jena Germany (DE) Universität Hamburg (UHH) Germany (DE)

How to cite

APA:

Draenert, R., Jung, N., Addo, M., Berner, R., Bickel, M., Bogner, J.R.,... Witzke, O. (2020). Update on the "Choosing Wisely" initiative in infectious diseases in Germany. Infection, 48(3), 317-321. https://doi.org/10.1007/s15010-020-01400-z

MLA:

Draenert, Rika, et al. "Update on the "Choosing Wisely" initiative in infectious diseases in Germany." Infection 48.3 (2020): 317-321.

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