Do not continue proton pump inhibitor (PPI) therapy chronically beyond the indications specified in the product label (e.g., 4–8 weeks for the treatment of gastroesophageal reflux disease); instead, reduce the dose (for example, from twice daily to once daily) or discontinue the PPI and use it on an as-needed basis.
Proton pump inhibitors (PPIs) should be used for the shortest duration possible, as long-term use (over 4–8 weeks) has been associated with increased risks of: deficiencies in essential nutrients such as calcium and vitamin B12, bone fractures, gastrointestinal...
Do not routinely switch from an intravenous formulation of an off-patent biologic drug to a subcutaneous formulation when a biosimilar intravenous formulation is available.
Biosimilars are approved by regulatory agencies after demonstrating comparable safety, efficacy, and immunogenicity to the reference (originator) product. They offer benefits such as reducing drug costs, improving treatment access, and fostering innovation. However,...
Do not prefer intravenous antibiotic formulations over oral ones if, after 48 hours of therapy, the patient (both pediatric and adult) meets the criteria for IV-to-oral switch, namely: afebrile, able to take oral medication, showing clinical improvement, and not affected by deep bacterial infections at high risk. (Green recommendation)
Numerous scientific studies have shown, and several guidelines (NICE, WHO) recommend, that intravenous antibiotic therapy should be promptly switched to oral therapy once the IV-to-oral (IV-PO) switch criteria are met—or discontinued if no longer necessary. The...
Do not postpone the start of a shared care planning with the patient, when the evolution of the disease makes it important to understand the expectations and desires of the sick person regarding possible choices at the end of life.
Shared planning of care is provided for by Law 219/2017 “Rules on Informed Consent and Advance Treatment Provisions”. It allows the sick person, if desired, and the treating physician to align themselves on the goals of care, on futile or disproportionate...The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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