{"id":2884,"date":"2018-10-17T19:08:03","date_gmt":"2018-10-17T17:08:03","guid":{"rendered":"https:\/\/choosingwiselyitaly.org\/raccomandazione-prof\/dont-prescribe-mf-59-adjuvated-influenza-vaccine-in-elderly-people\/"},"modified":"2026-01-29T17:36:19","modified_gmt":"2026-01-29T16:36:19","slug":"dont-prescribe-mf-59-adjuvated-influenza-vaccine-in-elderly-people","status":"publish","type":"raccomandazione-prof","link":"https:\/\/choosingwiselyitaly.org\/en\/raccomandazione-prof\/dont-prescribe-mf-59-adjuvated-influenza-vaccine-in-elderly-people\/","title":{"rendered":"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)"},"content":{"rendered":"<p>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\u2014or discontinued if no longer necessary. The criteria are as follows: <strong>A<\/strong> \u2013 Afebrile, <strong>B<\/strong> \u2013 Able to take oral medications, <strong>C<\/strong> \u2013 Clinically improving, <strong>D<\/strong> \u2013 Not affected by certain deep-seated or high-risk infections (e.g., osteomyelitis, endocarditis, meningitis, empyema, soft tissue infections, septic arthritis, sepsis, abscesses).<br \/>\nUnnecessary continuation of intravenous therapy increases the risk of infection and adverse events, requires more healthcare resources, may prolong hospital stays, and has a greater environmental impact.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"featured_media":2417,"template":"","meta":{"_edit_lock":["1769704665:2"],"_edit_last":["2"],"_wpml_media_duplicate":["0"],"_wpml_media_featured":["0"],"_thumbnail_id":["2417"],"_wpml_word_count":["190"],"_yoast_wpseo_primary_eta":[""],"_yoast_wpseo_primary_disciplina":["121"],"_yoast_wpseo_primary_tipologia":[""],"wpcf-pacchetto":["SIFACT #1"],"wpcf-bibliografia":["1. Waagsbo B, Sundoy A & Paulsen E. Reduction of unnecessary IV antibiotic days using general criteria for antibiotic switch Scand J Infectious Dis 2008; 40: 468-473. doi: 10.1080\/00365540701837134.\r\n2. Gasparetto J, Tuon FF, Dos Santos Oliveira D, et al. Intravenous-to-oral antibiotic switch therapy: a cross-sectional study in critical care units. BMC Infect Dis 2019;19:650. doi: 10.1186\/s12879-019-4280-0.\r\n3. Sze W T, Kong M C. Impact of printed antimicrobial stewardship recommendations on early intravenous to oral antibiotics switch practice in district hospitals. Pharm Pract (Granada) 2018;16:855. doi: 10.18549\/PharmPract.2018.02.855.\r\n4. Mertz D, Koller M, Haller P et al. Outcomes of early switching from intravenous to oral antibiotics on medical wards J Antimicrob Chemother 2009; 64: 188-199. doi: 10.1093\/jac\/dkp131.\r\n5. Schuts EC, Hulscher M, Mouton JW, et al. Current evidence on hospital antimicrobial stewardship objectives: a systematic review and meta-analysis. 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