Infection Control Experts Announce Recommendations to Reduce Overuse in Medicine


The Society for Healthcare Epidemiology of America (SHEA) has released a list of five practices to avoid for better infection prevention and control and safer care as part of the ABIM Foundation’s Choosing Wisely® campaign. The recommendations can support conversations between patients and physicians about what care is really necessary.

SHEA identified the five following recommendations:
• Don’t continue antibiotics beyond 72 hours in hospitalized patients unless the patient has a clear evidence of infection.
• Avoid invasive devices (including central venous catheters, endotracheal tubes and urinary catheters) and, if required, use no longer than necessary. They pose a major risk for infections.
• Don’t perform urinalysis, urine culture, blood culture or C. difficile testing unless patients have signs or symptoms of infection. Tests can be falsely positive leading to overdiagnosis and overtreatment.
• Don’t use antibiotics in patients with recent C. difficile without convincing evidence of need. Antibiotics pose a high risk of C. difficile recurrence.
• Don’t continue surgical prophylactic antibiotics after the patient has left the operating room.

“Fighting antibiotic resistance while improving the quality of care requires an all hands on deck approach,” says Anthony Harris, MD, MPH, president of the SHEA Board of Trustees. “We all have a role to play in making healthcare safer and using antibiotics appropriately. By joining this effort, we hope to start meaningful conversations between healthcare providers and patients.”

SHEA’s Choosing Wisely list was developed through careful consideration and review. A comprehensive list of recommendations was collected from members of the SHEA Guidelines, Public Policy and Government Affairs, Antibiotic Stewardship, Education, and Publications Committees with input from the SHEA Research Network. The five final recommendations were formally approved by the SHEA Guidelines Committee and Board of Trustees.

“Conversations about what care patients truly need is a shared responsibility among all members of the healthcare team,” says Richard J. Baron, MD, president and CEO of the ABIM Foundation. “SHEA’s Choosing Wisely list will help frontline medical staff across the country engage their patients in a dialogue about what care is best for them, and what we can do to reduce waste and overuse in our health care system.”

To date, more than 100 national and state medical specialty societies, regional health collaboratives and consumer partners have joined the conversation about appropriate care. With the release of this new list, the campaign will have covered more than 400 tests and procedures that the specialty society partners say are overused and inappropriate, and that physicians and patients should discuss.

The campaign also continues to reach millions of consumers nationwide through a stable of consumer and advocacy partners, led by Consumer Reports-the world’s largest independent product-testing organization-which has worked with the ABIM Foundation to distribute patient-friendly resources for consumers and physicians to engage in these important conversations.

To learn more about Choosing Wisely and to view the complete lists and additional detail about the recommendations and evidence supporting them, visit or go to

Source: Society for Healthcare Epidemiology of America

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