AAP’s list of don’ts grows

The American Academy of Pediatrics (AAP) recently released another list of tests and treatments that you should think twice about before employing.

The AAP says that the tests and treatments are not always necessary and can even be harmful. The next list is part of the Choosing Wisely^® initiative of the American Board of Internal Medicine Foundation.

The latest list includes:

1. Don’t prescribe high-dose dexamethasone (0.5 mg/kg per day) to prevent or treat bronchopulmonary dysplasia in preterm infants.

2. Don’t perform screening panels for food allergies without considering the child’s medical history.

3. Don’t use acid blockers and motility agents, such as metoclopramide, for physiologic gastroesophageal reflux (GER) that is effortless, painless, and not affecting growth. And don’t prescribe medication for the so-called “happy spitter.”

4. Avoid using surveillance cultures to screen for and treat asymptomatic bacteriuria.

5. Do not routinely use infant home apnea monitors in an effort to prevent sudden infant death syndrome (SIDS).

With the release of these new items, the campaign will now cover more than 250 tests and procedures that are overused and sometimes inappropriate and that should be discussed by physicians and patients before pursuing. To view the complete lists, additional information about the recommendations, and the evidence supporting them, visit www.choosingwisely.org/doctor-patient-lists/.

The AAP also recently launched its online communication module for 2 items on its previous list released 1 year ago. The module addresses appropriate use of antibiotics and when to order computed tomography scans for minor head injuries. 

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