Feasibility of subcutaneous antibiotics for palliative care patients

Abstract

AimWe conducted a narrative review of the literature to better understand the use of subcutaneous administration, especially in palliative care patients with an infection. The aim of this review is to determine the feasibility of using subcutaneous antibiotics in palliative care patients. No ethical approval was needed.

Perceptions of health professionals on subcutaneous hydration in palliative care: A qualitative study

“…With regard to the sub-themes and categories which emerged in the discussions about the essential elements in the procedure of administering subcutaneous fluids (third theme), these are in line with the information on recommendations of use contained in the review studies 18,20 and in the guidelines or reports. 23 Eight sub-themes emerged relating to the type of catheters to use and their maintenance, the puncture areas and their characteristics, the infusion systems and the type and volume of the fluid and its potential side effects.…”

“…The advantages of hypodermoclysis include the simplicity of starting or re-starting it and of its maintenance, the little amount of training required for establishing and maintaining it, the low number of side effects (infection, haematomas, oedemas), its low cost, the possibility of it being used at home by a member of the family, its high acceptance level among patients and professionals and the possibility of using it with some drugs and infusions of up to 3000 mL/day through two infusion areas. 20,22–24…”

Off-label drug use in palliative care – a narrative review

“…W niedawno opublikowanym duńskim badaniu obserwacyjnym wykazano, że dwie trzecie leków podawanych podskórnie nie miało wskazań rejestracyjnych [14]. Podskórnie można podawać na przykład niektóre antybiotyki, takie jak amikacyna, stosowana w leczeniu zakażeń pałeczkami Gram ujemnymi, ceftriakson czy cefalosporyny III gene racji o szerokim spektrum działania bakteriobójcze go, które są dopuszczone do podskórnego podania we Francji [15,16]. Antybiotyki te obejmują swoim działaniem dużą grupę zakażeń rozwijających się u pacjentów pod koniec życia, co umożliwia leczenie infekcji bez konieczności hospitalizacji.…”

Single-dose pharmacokinetics of temocillin in plasma and soft tissues of healthy volunteers after intravenous and subcutaneous administration: a randomized crossover microdialysis trial

“…2 In this context, the subcutaneous route has proven to be a practical and increasingly important alternative way of administering drug therapy. 3 Establishing the subcutaneous route as an equivalent mode of administration would allow minimization of nursing care in situations where oral, intravenous or intramuscular dosing is difficult to achieve. Subcutaneous dosing has already been described for a number of antimicrobial drugs, with little or no difference in overall exposure and only minor local tolerability issues compared with intravenous infusion.…”