American Podiatric Medical Association
View all recommendations from this societyReleased January 19, 2022
Don’t prophylactically use compounded antibiotic soaks for aftercare following office-based procedures (e.g., nail and skin lesion removal).
The marked increase of prescribing and dispensing of compounded antibiotic powders for soaking after non-complicated office-based procedures has shown no more effectiveness than the current standard (i.e., over-the-counter Betadine, white vinegar, astringent soaks and Epsom salts) while having the obvious downside of adding significant overall cost to in-office procedures. The hundreds of dollars being spent on these expensive substitutes represents medical waste.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.
How The List Was Created
(1–5) The American Podiatric Medical Association’s (APMA) Clinical Practice Advisory Committee, consisting of APMA members, board members, young members and liaisons with special interests in a variety of subspecialty areas within podiatric practice, formulated the recommendations for the ABIM Foundation’s Choosing Wisely Campaign. The Committee worked with podiatric colleagues to create an initial list of recommendations, which was reviewed and narrowed down to eight recommendations. The list of eight recommendations was further developed and distributed to the Committee for ranking in numerical order. Committee members were asked to rank the recommendations based on their relevance, timeliness, strength of supporting evidence and appropriateness for inclusion in the Choosing Wisely Campaign. The rankings and deliberation enabled the Committee to come to the final five recommendations, which were again reviewed to ensure appropriate evidence was used to support each recommendation. The final recommendations were approved by the Board of Trustees of the APMA before submission to the ABIM Foundation.
(6–10) The American Podiatric Medical Association (APMA) tasked their Clinical Practice Advisory Committee consisting of APMA members, board members, young members, and liaisons with special interests in a variety of subspecialty areas within podiatric practice to formulate the recommendations for the ABIM Foundation’s Choosing Wisely Campaign. The Committee worked with podiatric colleagues to create an initial list of recommendations, which was reviewed and narrowed down to nine recommendations. The list of nine recommendations was further developed and distributed to the Committee for ranking in numerical order. Committee members were asked to rank the recommendations based on their relevance, timeliness, strength of supporting evidence and appropriateness for inclusion in the Choosing Wisely Campaign. The rankings and deliberation allowed the Committee to come to the final five recommendations, which were again reviewed to ensure appropriate evidence was used to support each recommendation. The final recommendations were approved by the Board of Trustees of the APMA before submission to the ABIM Foundation.
APMA’s disclosure and conflict of interest policy can be found at www.apma.org.
Sources
There are no peer-reviewed studies to support the use of compounded antibiotic powders over what is currently available for soaking after non-complicated office-based nail and/or skin procedures. There are low-cost alternatives available currently.\
No reference could be found to support the use of these soaking powders as far as being overall more effective than standard current soaking materials in non-complicated, otherwise-healthy patients.
