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Walk the evidence base by book and chapter — the raw source passages that ground Ask, Differential, and the rest.
9 passages
Fixed-dose combinations of antibiotics (e.g., ofloxacin+ornidazole, cefpodoxime+clavulanic acid) for non-specific indications are low-value. Why: Combination antibiotics should be reserved for specific polymicrobial infections; routine use increases resistance and cost without improving outcomes.
Unindicated antibiotic prescriptions without documented bacterial infection are low-value and inappropriate. Why: Antibiotics should only be prescribed when there is clear evidence of bacterial infection to avoid resistance and unnecessary side effects.
Antibiotics prescribed for viral upper respiratory tract infections (URTI), pharyngitis, or gastroenteritis are low-value in primary care settings. Why: Viral infections are self-limiting and do not respond to antibiotics; their use promotes resistance and adverse effects without clinical benefit.
Co-prescription of fluoroquinolones (ofloxacin, ciprofloxacin) with domperidone or ondansetron constitutes a major drug interaction and is low-value. Why: Multiple major interaction findings involve QT-prolonging combinations of fluoroquinolones with prokinetics or antiemetics.
Prescribing antibiotics, including fluoroquinolone combinations, for conditions documented as likely viral gastroenteritis is proposed as low-value care. Why: Most cases of acute gastroenteritis are viral and self-limiting, making antibiotics unnecessary and potentially harmful.
Co-prescribing medications with known major drug-drug interactions, such as ofloxacin+ornidazole with ondansetron, is proposed as low-value care. Why: This practice poses a significant risk of adverse events, such as QT prolongation, which can be avoided with alternative therapies.
Prescribing an antibiotic without a documented, evidence-based bacterial indication is proposed as low-value care. Why: This practice increases the risk of adverse effects, drug interactions, and antimicrobial resistance without clear patient benefit.
Co-prescribing Ofloxacin+Ornidazole with Ondansetron is low-value care due to a major drug-drug interaction. Why: This combination carries a risk of significant adverse events, such as QT prolongation and serotonin syndrome.
Prescribing fixed-dose combinations containing multiple antimicrobials (e.g., azithromycin/fluconazole/secnidazole, ofloxacin/ornidazole) is low-value care. Why: Such combinations are often irrational, may be banned, and increase the risk of adverse drug interactions and resistance.