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The present article describes the history of risk management, how it was born and how it has evolved, with a specific focus on healthcare. Risk management was a strategy initially used primarily in the economic and business sector. We analysed how the continuous increase of medical malpractice lawsuits involving demands for compensation led to the adoption of risk management strategies in healthcare. The various clinical risk-management strategies adopted in different countries and in different historical periods are also described.

The practice of defensive medicine is an emerging problem in public health. A common practice of defensive medicine is excessive antibiotic prescribing which is well known to lead to antibiotic resistance, an important public health priority worldwide, not only for its clinical implications (increased morbidity, mortality, duration of illness, frequent development of complications and outbreaks), but also for the economic impact of antibiotic-resistant infections which lead to additional costs related to the use of more expensive drugs and procedures and to longer length of illness and hospital stays. Also, the emergence of pathogens resistant to multiple antibiotics reduces the possibility of an effective treatment. The present study investigated susceptibility to antibiotics of 115 strains of Ureaplasma urealyticum identified in urethral swabs. Patients who provided samples had a mean age of 41 years. Strains were 96% resistant to ciprofloxacin and 99% sensitive to doxycycline and pristinamycin and 98% to josamycin. Results were comparable to those of a previous study by Savarino and Mattei.