In a patient with fatigue, avoid performing multiple serological investigations, without a clinical indication or relevant epidemiology.
Multiple serological testing as investigation for a patient with fatigue, is not recommended. If such testing is not clinically indicated there is a risk of false positive results leading to further unnecessary investigations and useless treatments
- Oldmeadow M, Lloyd A. Fatigue states following infection. Infectious Diseases: A clinical approach. Third Edition. 2010, Chapter 17, 202-212.
- Lane TJ, Matthews DA, Manu P. The low yield of physical examinations and laboratory investigations of patients with chronic fatigue. The American Journal of Medical Science 1990:299(5):313-8.
- Therapeutic Guidelines Limited. Fatigue: diagnostic approach to fatigue in primary care. Melbourne, 2011.
An initial list of 10 low value interventions was compiled by the Lead Fellow of the Australasian Society for Infectious Diseases (ASID) Inc following an online discussion in ASID's discussion forum, Ozbug. The Royal Australasian College of Physicians (RACP) then facilitated a consultation of all ASID members via a survey distributed through the society’s e-newsletter. In the survey, members were asked to rank the 10 suggested interventions and suggest additional items for consideration. A subsequent shortlist of items was created by selecting the top 7 interventions as ranked by the members from the initial list.
The shortlist was sent to ASID’s special interest groups and selected members who had agreed to assist, who were asked to recommend the items to comprise the ‘top 5’. This final list was endorsed by ASID Council on 31 July 2015. The Top 5 was then circulated again to the ASID members for final comments before being signed off by ASID’s Executive Committee.
- 1 Do not use antibiotics in asymptomatic bacteriuria.
- 2 Do not take a swab or use antibiotics for the management of a leg ulcer without clinical infection.
- 3 Avoid prescribing antibiotics for upper respiratory tract infection.
- 4 Do not investigate or treat for faecal pathogens in the absence of diarrhoea or other gastro-intestinal symptoms.
- 5 In a patient with fatigue, avoid performing multiple serological investigations, without a clinical indication or relevant epidemiology.