1. 1

    Do not use antibiotics in asymptomatic bacteriuria

  2. 2

    Do not take a swab or use antibiotics for the management of a leg ulcer with no indication of clinical infection

  3. 3

    Avoid prescribing antibiotics for upper respiratory tract infections (with the exception of sore throat in populations at high risk for complication of group A strep infection, such as acute rheumatic fever or post-streptococcal glomerulonephritis)

  4. 4

    Do not investigate or treat for faecal pathogens in the absence of diarrhoea or other gastrointestinal symptoms

  5. 5

    In a patient with fatigue, avoid performing multiple serological investigations without a clinical indication or relevant epidemiology

How this list was developed

In 2015, 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 across 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 recommend 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 were asked to recommend the items that should comprise the Top 5. This final list was endorsed by the ASID Council on 31 July 2015. The Top 5 was circulated again to the ASID members for final comments before being approved by ASID’s Executive Committee.​

In 2019 following a review by the Executive Committee in response to a comment by Choosing Wisely New Zealand, recommendation 3 was amended. The amended recommendation was then duly consulted with all internal and external stakeholders with an interest and expertise in the subject matter of the amended recommendation.