National antimicrobial intravenous-to-oral switch (IVOS) criteria for prompt switch for adults
Updated 25 October 2024
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The national antimicrobial intravenous-to-oral switch (IVOS)바카라 사이트¯criteria for prompt switch바카라 사이트‹ contains 24 IVOS criteria categorised into 5 sections. This criteria was co-produced through a UK-wide consensus process 바카라 사이트‹involving 279 multidisciplinary participants바카라 사이트‹.
Timing of intravenous (IV) antimicrobial review바카라 사이트‹
IVOS should be considered within 48 hours of the first dose of IV antimicrobial being administered.바카라 사이트‹
If no IVOS within first 48 hours, review daily thereafter.바카라 사이트‹
Clinical signs and symptoms바카라 사이트‹
Clinical signs and symptoms of infection are improving.바카라 사이트‹
Infection markers 바카라 사이트‹
Temperature has been between 36 to 38°C for the past 24 hours.바카라 사이트‹
Early Warning Score is decreasing.바카라 사이트‹
White Cell Count is trending towards the normal range.*바카라 사이트‹
C-Reactive Protein is decreasing.*바카라 사이트‹
*Note: these infection markers could also indicate inflammation or be affected by, for example, steroid treatment; 바카라 사이트˜Prompt for switch바카라 사이트™ or 바카라 사이트˜Assess for switch바카라 사이트™ may still occur if they are the only markers not met.바카라 사이트‹
Enteral route바카라 사이트‹
Gastrointestinal tract must be functioning with no evidence of malabsorption.바카라 사이트‹
Safe swallow or enteral tube administration.바카라 사이트‹
Suitable oral switch option available, considering oral bioavailability, any clinically significant drug interactions or patient allergies.바카라 사이트‹
No significant concerns over patient adherence to oral treatment.바카라 사이트‹
No vomiting within the last 24 hours.바카라 사이트‹
Special considerations 바카라 사이트‹
Special considerations are:
- deep-seated infection
- infection requiring high tissue concentration
- infection requiring prolonged intravenous antimicrobial therapy
- critical infection with high risk of mortality
Specific infections for special consideration are:
- bloodstream infection
- empyema
- endocarditis
- meningitis
- osteomyelitis
- severe or necrotising soft tissue infections
- septic arthritis
- undrained abscess
Antimicrobial IVOS criteria and tool 바카라 사이트“ project information바카라 사이트‹
These IVOS criteria have been developed through:바카라 사이트‹
- collation of criteria from a sample of 45 acute hospital IVOS policies 바카라 사이트‹
- completion of a rapid systematic literature review to validate selection of IVOS criteria바카라 사이트‹
- 4-step Delphi consensus-gathering process involving 279 multidisciplinary participants from all UK nations to agree evidence-based, UK-wide IVOS criteria for hospitalised adult patients바카라 사이트‹
The Delphi process consisted of:바카라 사이트‹
- Step 1: pilot/first round questionnaire (24 respondents)바카라 사이트‹
- Step 2: virtual meeting to discuss findings of pilot/first round questionnaire (15 participants)바카라 사이트‹
- Step 3: second round questionnaire (242 respondents) 바카라 사이트‹
- Step 4: workshop (48 pre-workshop survey respondents and 33 workshop participants)바카라 사이트‹
The total of 279 participants across the 4-step process accounts for individuals who provided expert advice outside of questionnaires, virtual meeting and workshop, and ensures individuals who participated in more than one step are only included once in total count. 바카라 사이트‹
This project has been led by the UK Health Security Agency (UKHSA)바카라 사이트™s Healthcare-Associated Infection, Fungal, Antimicrobial Resistance, Antimicrobial Use and Sepsis Division, in collaboration with NHS England AMR Programme and UKHSA바카라 사이트™s Behavioural Science and Insights Unit. 바카라 사이트‹
Clinicians can access the IVOS Commissioning for Quality and Innovation (CQUIN) data collection tool on the .