Antibiotics by Subcutaneous Route: A Safe and Efficient Alternative

Safety of Subcutaneous Piperacillin/Tazobactam Administration Compared to Intravenous Administration: Propensity Score–Matched Cohort Study

“…The authors found that each additional medication taken cumulatively for 24 months decreased renal function and, in a high-risk subgroup, per NSAID taken cumulatively for 24 months, the renal function decreased by 1.21 mL/min/1.73 m 2 estimated glomerular filtration rate. 1 In the present study, the cumulative uptake of NSAIDs was found to be associated with a nearly 3-fold reduction in renal function. We think that some methodological issues should be taken into consideration while determining the relationship between longterm NSAID use and renal disease in older adults.…”

“…We think that some methodological issues should be taken into consideration while determining the relationship between longterm NSAID use and renal disease in older adults. 1 NSAIDs are used frequently in older people, both in acute pain and mainly in cases such as knee osteoarthritis, which causes chronic pain. 2 However, NSAIDs have numerous adverse side effects, such as hypertension, congestive heart failure, electrolyte imbalance, and edema.…”

“…3 This means that in Ernst et al's study, the patients who used NSAIDs for more than 24 months had been probably or should have been receiving PPI at the same time. 1 PPIs are one of the most commonly prescribed drugs in older people, and it is estimated that between 25% and 70% of the prescriptions have no appropriate indication. 4 The use of chronic NSAIDs is on the top of the indications for which PPIs are recommended.…”

“…4 Therefore, in the study by Ernst et al, who investigated the effect of polypharmacy and NSAIDs on renal function, it is an important limitation that PPIs, which are the most common drugs to cause polypharmacy, were not evaluated simultaneously with NSAIDs. 1,5 In that study, it should have been checked whether PPI use contributed to the 3-fold cumulative…”

Local Tissue Response to Subcutaneous Administration of Ceftriaxone in an Animal Model

“…Subcutaneous antibiotic administration can be considered a novel and transformative approach to OPAT. It could be an appealing option for the elderly, especially those in palliative care settings, when other common (e.g., oral, intravenous, or intramuscular) routes of drug administration are unavailable or infeasible (2,5,6). The advantages of outpatient care with subcutaneous antibiotics could liberate patients, caregivers, practitioners, and payers from the costs as well as constraints of inpatient care.…”