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Don't use antimicrobials to treat asymptomatic bacteriuria. Setting: positive urine culture in a patient with no urinary symptoms (excluding pregnancy and pre-urologic-procedure settings) Why: Treating asymptomatic bacteriuria does not improve outcomes and promotes resistance, C. difficile, and drug adverse effects. Consider instead: no treatment; treat only symptomatic urinary tract infection Source: Infectious Diseases Society of America (Choosing Wisely, US, 2015).
Don't prescribe antibiotics for acute pharyngitis without confirmed or high-probability group A streptococcal infection. Setting: acute pharyngitis without laboratory confirmation of group A streptococcus and without a high-probability presentation (low Centor/McIsaac score) Why: Most acute sore throats are viral; antibiotics without strep confirmation do not shorten illness and expose patients to adverse effects and resistance. Consider instead: symptomatic treatment; apply a validated score (Centor/McIsaac) and confirm strep (RADT/culture) before antibiotics Source: Infectious Diseases Society of America (Choosing Wisely, US, 2012).