A survey of subcutaneous blood flow in patients with SMID and subcutaneous ceftazidime administration using mentholated warm compresses in healthy subjects

Abstract

ObjectivesTo investigate subcutaneous blood flow rate (SBFR) in healthy volunteers and patients with severe motor and intellectual disabilities (SMID), and evaluate the effect of mentholated warm compresses (MWCs) on SBFR and subcutaneous ceftazidime absorption in healthy volunteers.MethodsSBFR at the forearm, chest and abdomen were evaluated in Japanese healthy volunteers and in adults with SMID. The effects of MWCs on blood flow rate and ceftazidime pharmacokinetics were evaluated in healthy volunteers.ResultsSBFR was significantly lower in the forearms of female patients with SMID (n = 11) than in the forearms of healthy females (n = 6); it was not significantly lower in the abdomen or chest. There were no significant differences between male patients (n = 18) or controls (n = 12) in SBFR at any site. MWC application increased SBFR 1.3- to 2.0-fold compared with baseline in healthy controls (n = 6). MWC application increased ceftazidime maximum blood concentration, SBFR and time above mutant prevention concentration in a single healthy subject.ConclusionsAbdominal SBFR in patients with SMID did not differ from that of healthy subjects. MWC application increases SBFR and subcutaneous drug absorption rate in healthy humans.

A successful antibiotic treatment by a new administration route: a case report of a subcutaneous administration of ceftazidime and tobramycin

“…However, it must be reminded that the subcutaneous administration of cephalosporin is potentially harmful, as published in a recent study on ceftriaxone [10]. A study, performed among healthy subjects (n = 18) and subjects with severe motor intellectual disabilities (n = 29), showed that subcutaneous ceftazidime bioavailability increased with the use of mentholated warm compresses (i.e., by increasing blood flow rate) [11]. The time to complete systemic diffusion of ceftazidime was 120 min with mentholated warm compresses vs. 205 min without, and the maximum ceftazidime plasma concentration was 57.4 lg/mL vs. 44.8 lg/mL, respectively.…”

The Subcutaneous Administration of Beta-Lactams: A Case Report and Literary Review—To Do Small Things in a Great Way

“…infusion. However the area under the concentration-time curve (AUC), the minimum blood concentration (C min ) and the t 1/2 was comparable between the two different administration routes [5][6][7][8].…”

“…Some authors attempted to enhance the absorption of cephalosporins through s.c. administration by using some agents that increase connective tissue permeability, such as hyaluronidase, or the subcutaneous blood flow rate (such as mentholated warm compresses) [6,7]. These strategies appeared to exert a favorable influence on cephalosporin C max and T max when administered subcutaneously.…”

Subcutaneous Antibiotic Therapy: The Why, How, Which Drugs and When

“…68e71 Also, interestingly, simple tools like mentholated warm compresses, may improve the SC blood flow rate and absorption of antibiotics. 50 The SC route may be a useful resource in the treatment of ambulatory patients in developing countries, as well as vulnerable patients (including IV drug users), people in remote locations, and in finding applications in military medicine.…”