Don’t routinely prescribe Proton Pump Inhibitors (PPI) in patients without risk factors for ulcer disease. In gastroesophageal reflux disease prescribe the lowest dose that can control symptoms and educate the patient to desirable withdrawal periods.
PPI are usually prescribed to avoid drug induced gastropathy. This procedure showed to be effective for NSAIDs, but not for steroids, anticoagulants, antineoplastic agents, antibiotics. PPI intake is related to an increased risk of intestinal and lung infections in...
Don’t routinely prescribe antibiotics for acute upper airway infections. Assess the opportunity in patients at risk of lower respiratory tract infection or in case of clinical worsening after a few days
Upper respiratory tract infections (including acute otitis media) are usually caused by viruses and recover spontaneously in a few days. The routine use of antibiotics raises the risk of bacterial resistance and side effects. Patients at risk of lower respiratory...
Don’t routinely prescribe imaging for low back pain without warning signs or symptoms (Red Flags)
Low back pain is usually benign and self-limiting. The history and physical examination, inclusive of neurological assessment, can exclude serious clinical situations. Imaging in low back pain without Red Flags is in generally inappropriate (at least for the first 6...
Don’t perform HLA genotyping in the presence of established diagnosis of celiac disease or for screening purpose.
HLA-DQ2/DQ8 genotyping is appropriate only in cases of uncertain diagnosis and in subjects with increased risk, like family members of celiac patients (to exclude from subsequent repeated controls the subjects who are negative) and patients with a disease implying an...The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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