Table 5.

American Academy of Allergy, Asthma and Immunology Choosing Wisely Recommendations: 10 Things Physicians and Patients Should Question³⁴

1. Don’t perform unproven diagnostic tests, such as IgG testing or an indiscriminate battery of IgE tests, in the evaluation of allergy.

2. Don’t order sinus CT or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis.

3. Don’t routinely perform diagnostic testing in patients with chronic urticaria.

4. Don’t recommend replacement immunoglobulin therapy for recurrent infections unless impaired antibody responses to vaccines are demonstrated.

5. Don’t diagnose or manage asthma without spirometry.

6. Don’t rely on antihistamines as first-line treatment in severe allergic reactions.

7. Don’t perform food IgE testing without a history consistent with potential IgE-mediated food allergy.

8. Don’t routinely order low- or iso-osmolar radiocontrast media or pretreat with corticosteroids and antihistamines for patients with a history of seafood allergy who require radiocontrast media.

9. Don’t routinely avoid influenza vaccination in egg-allergic patients.

10. Don’t overuse non-beta lactam antibiotics in patients with a history of penicillin allergy without an appropriate evaluation.

Abbreviations: CT, computed tomography; IgE, immunoglobulin E; IgG, immunoglobulin G.