Doctors say children with middle ear infections aged between two and 12 should not be given routine antibiotics.
It is just one of more than 60 recommendations for tests, treatments and procedures that could be unnecessary and may even cause harm to Australian patients, Dr Lynn Weekes from NPS MedicineWise said.
NPS MedicineWise, a not-for-profit group, has released details of the new recommendations under the Choosing Wisely campaign to encourage doctors and patients to question whether tests, scans and treatments were necessary.
Many of the recommendations focused on the need for appropriate use of antibiotics to reduce antibiotic resistance.
Dr Frank Jones from the Royal Australian College of General Practitioners said the college recommended against routine antibiotics for middle ear infections in children aged two to 12.
“Recommendations include ensuring appropriate antibiotic use for urinary tract infection, upper respiratory infection, leg ulcers, epidermal cysts, acne, and daily consideration of antibiotic de-escalation for intensive care patients,” he said.
“The small benefits of antibiotic use must be weighed up against the risk and potential side-effects, such as rash and diarrhoea, and [that] antibiotics do not reduce pain at 24 hours.”
The Choosing Wisely campaign brings together a coalition of medical colleges and professional associations which have drawn up their own lists of potentially unnecessary tests and treatments.
It is based on a concept that was developed in the United States.
The campaign is designed to make sure that patients do not undergo unnecessary procedures that may be potentially harmful.
Other recommendations included:
- That patients with acute uncomplicated chest bronchitis do not need a chest X-ray
- To not request imaging for patients with non-specific lower-back pain
- To avoid prescribing antibiotics for upper respiratory tract infections.
Unnecessary imaging scans expose patients to radiation
Royal Australasian College of Surgeons president Michael Donovan said routine imaging could cause adverse events and lead to further unnecessary investigations. He said it may also cause unnecessary exposure to radiation.
“As an example of identifying tests, treatments and procedures that carry unnecessary risk for patients, one of our recommendations centres on reducing radiation exposure,” he said.
“Ultrasound, not CT scans, is the preferred first approach, as it is cost-effective, reduces potential radiation risks for children and has excellent accuracy.”
Fourteen Australian colleges, societies and associations have united to join the Choosing Wisely campaign.
The full list of recommendations can be seen at the Choosing Wisely website.