Choosing Wisely



Don’t use antimicrobials to treat bacteriuria in non-pregnant adults unless specific urinary tract symptoms are present. Cohort studies have found no adverse outcomes for older men or women associated with asymptomatic bacteriuria.


In pts with low pretest probability of venous thromboembolism (VTE), order a high-sensitive D-dimer as the initial diagnostic test; don’t start with imaging.


Don’t prescribe medications for stress ulcer prophylaxis to medical inpatients unless at high risk for GI complications.  


Do not order folate levels at all. In adults, consider folate supplementation instead of serum folate testing in patients with macrocytic anemia


Don’t test for Clostridium difficile infection in the absence of diarrhea. (The lab won’t even run the sample if stool is formed)


Don’t continue antibiotics > 72 hours in hospitalized pts unless pt has clear evidence of infection.