TY - JOUR
T1 - Update on the “Choosing Wisely” initiative in infectious diseases in Germany
AU - the Choosing Wisely (Klug entscheiden) DGI Working Group
AU - Draenert, Rika
AU - Jung, Norma
AU - Addo, Marylyn M.
AU - Berner, Reinhard
AU - Bickel, Markus
AU - Bogner, Johannes
AU - Cornely, Oliver
AU - de With, Katja
AU - Fätkenheuer, Gerd
AU - Hagel, Stefan
AU - Hanses, Frank
AU - Harrer, Thomas
AU - Hartmann, Pia
AU - Herold, Susanne
AU - Hippenstiel, Stefan
AU - Kern, Winfried
AU - Klauke, Stephan
AU - Klinker, Hartwig
AU - Lehmann, Clara
AU - Lemmen, Sebastian
AU - Lübbert, Christoph
AU - Pletz, Mathias W.R.
AU - Rieg, Siegbert
AU - Ruf, Bernhard R.
AU - Rupp, Jan
AU - Salzberger, Bernd
AU - Slevogt, Hortense
AU - Stellbrink, Hans Jürgen
AU - Stephan, Christoph
AU - Suttorp, Norbert
AU - Ullmann, Andrew
AU - Witzenrath, Martin
AU - Witzke, Oliver
N1 - Funding Information:
Open Access funding provided by Projekt DEAL. We thank the ?Klug entscheiden? DGI Working Group for suggestions of topics and critical review of the final recommendations. The members of the Choosing Wisely (Klug entscheiden) DGI Working Group are Marylyn M. Addo, Reinhard Berner, Markus Bickel, Johannes Bogner, Oliver Cornely, Katja de With, Gerd F?tkenheuer, Stefan Hagel, Frank Hanses, Thomas Harrer, Pia Hartmann, Susanne Herold, Stefan Hippenstiel, Winfried Kern, Stephan Klauke, Hartwig Klinker, Clara Lehmann, Sebastian Lemmen, Christoph L?bbert, Mathias W. R. Pletz, Siegbert Rieg, Bernhard R. Ruf, Jan Rupp, Bernd Salzberger, Hortense Slevogt, Hans-J?rgen Stellbrink, Christoph Stephan, Norbert Suttorp, Andrew Ullmann, Martin Witzenrath, Oliver Witzke.
Publisher Copyright:
© 2020, The Author(s).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85081916712&partnerID=8YFLogxK
U2 - 10.1007/s15010-020-01400-z
DO - 10.1007/s15010-020-01400-z
M3 - Scientific review articles
C2 - 32157610
AN - SCOPUS:85081916712
SN - 0300-8126
VL - 48
SP - 317
EP - 321
JO - Infection
JF - Infection
IS - 3
ER -
