Subcutaneous and intravenous ceftriaxone administration in patients more than 75 years of age

Gauthier, Dorothy K.; Schambach, S.; Crouzet, Julien; Sirvain, S.; Fraisse, T.

doi:10.1016/j.medmal.2014.03.007

Cited by 30 publications

(36 citation statements)

References 21 publications

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“…Compared with the IV group, patients in the SC group were significantly older, more often bedridden, and more frequently had dementia. 61 The reasons for using SC administration in weaker patients include a difficult venous access, risks related to venous access, and difficulty to maintain the venous access, especially in patients presenting with cognitive or behavioral disorders. Nevertheless, this does not justify an excessive use of SC administration, as for septic shock.…”

Section: Resultsmentioning

confidence: 99%

The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

Jin¹,

Zhu²,

Chen³

et al. 2015

PPA

131

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BackgroundIntravenous (IV), intramuscular (IM), and subcutaneous (SC) are the three most frequently used injection routes in medication administration. Comparative studies of SC versus IV, IM versus IV, or IM versus SC have been sporadically conducted, and some new findings are completely different from the dosage recommendation as described in prescribing information. However, clinicians may still be ignorant of such new evidence-based findings when choosing treatment methods.MethodsA literature search was performed using PubMed, MEDLINE, and Web of Sciences™ Core Collection to analyze the advantages and disadvantages of SC, IV, and IM administration in head-to-head comparative studies.Results“SC better than IV” involves trastuzumab, rituximab, antitumor necrosis factor medications, bortezomib, amifostine, recombinant human granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, recombinant interleukin-2, immunoglobulin, epoetin alfa, heparin, and opioids. “IV better than SC” involves ketamine, vitamin K1, and abatacept. With respect to insulin and ketamine, whether IV has advantages over SC is determined by specific clinical circumstances. “IM better than IV” involves epinephrine, hepatitis B immu-noglobulin, pegaspargase, and some antibiotics. “IV better than IM” involves ketamine, morphine, and antivenom. “IM better than SC” involves epinephrine. “SC better than IM” involves interferon-beta-1a, methotrexate, human chorionic gonadotropin, hepatitis B immunoglobulin, hydrocortisone, and morphine. Safety, efficacy, patient preference, and pharmacoeconomics are four principles governing the choice of injection route. Safety and efficacy must be the preferred principles to be considered (eg, epinephrine should be given intramuscularly during an episode of systemic anaphylaxis). If the safety and efficacy of two injection routes are equivalent, clinicians should consider more about patient preference and pharmacoeconomics because patient preference will ensure optimal treatment adherence and ultimately improve patient experience or satisfaction, while pharmacoeconomic concern will help alleviate nurse shortages and reduce overall health care costs. Besides the principles, the following detailed factors might affect the decision: patient characteristics-related factors (body mass index, age, sex, medical status [eg, renal impairment, comorbidities], personal attitudes toward safety and convenience, past experience, perception of current disease status, health literacy, and socioeconomic status), medication administration-related factors (anatomical site of injection, dose, frequency, formulation characteristics, administration time, indication, flexibility in the route of administration), and health care staff/institution-related factors (knowledge, human resources).ConclusionThis updated review of findings of comparative studies of different injection routes will enrich the knowledge of safe, efficacious, economic, and patient preference-oriented medication administration as well as...

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Section: Resultsmentioning

confidence: 99%

The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

Jin¹,

Zhu²,

Chen³

et al. 2015

PPA

131

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“…Ceftriaxone is the most used antibiotic for subcutaneous injection in France and appears really interesting to treat streptococcal native valve IE. However, very few pharmacokinetic and clinical data are available until now 54–57. Teicoplanin has also been used subcutaneously with very scarce published data 58,59.…”

Section: Management Of Ie In the Elderlymentioning

confidence: 99%

Managing infective endocarditis in the elderly: new issues for an old disease

Forestier¹,

Fraisse²,

Baudron³

et al. 2016

CIA

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The incidence of infective endocarditis (IE) rises in industrialized countries. Older people are more affected by this severe disease, notably because of the increasing number of invasive procedures and intracardiac devices implanted in these patients. Peculiar clinical and echocardiographic features, microorganisms involved, and prognosis of IE in elderly have been underlined in several studies. Additionally, elderly population appears quite heterogeneous, from healthy people without past medical history to patients with multiple diseases or who are even bedridden. However, the management of IE in this population has been poorly explored, and international guidelines do not recommend adapting the therapeutic strategy to the patient’s functional status and comorbidities. Yet, if IE should be treated according to current recommendations in the healthiest patients, concerns may rise for older patients who suffer from several chronic diseases, especially renal failure, and are on polypharmacy. Treating frailest patients with high-dose intravenous antibiotics during a prolonged hospital stay as recommended for younger patients could also expose them to functional decline and toxic effect. Likewise, the place of surgery according to the aging characteristics of each patient is unclear. The aim of this article is to review the recent data on epidemiology of IE and its peculiarities in the elderly. Then, its management and various therapeutic approaches that can be considered according to and beyond guidelines depending on patient comorbidities and frailty are discussed.

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“…Ceftriaxone has a marketing authorization for that route, but published evidence on its efficacy and safety is limited [4][5][6][7]. Administering aminoglycosides sc is formally contraindicated by recently published French guidelines because of uncertain efficacy and risk of skin necrosis (http://ansm.sante.fr/Dossiers/Antibiotiques/Autresrecommandations-impliquant-des-antibiotiques/(offset)/8).…”

Section: Discussionmentioning

confidence: 99%

Subcutaneously administered antibiotics: a national survey of current practice from the French Infectious Diseases (SPILF) and Geriatric Medicine (SFGG) society networks

Forestier

Pocard

Roubaud-Baudron

et al. 2015

Clinical Microbiology and Infection

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A national survey was performed to explore antibiotic prescription by the subcutaneous (sc) route among French infectious diseases and geriatric practitioners. Among the participating physicians, 367 (96.1%) declared administering sc antibiotics at some point. Ceftriaxone was prescribed sc by all but one, and ertapenem, teicoplanin, aminoglycosides and amoxicillin by 33.2%, 39.2%, 35.1% and 15.3%, respectively. The sc route was resorted to mainly in case of unavailable oral, intravenous or intramuscular routes, especially during palliative care. Pain, skin necrosis and lack of efficacy were the main adverse effects, reported by 70.8%, 12.8% and 19.9% of practitioners, respectively. Further studies are needed to precise the indications, modalities and tolerance of sc antibiotic use.

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Subcutaneous and intravenous ceftriaxone administration in patients more than 75 years of age

Cited by 30 publications

References 21 publications

The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

Managing infective endocarditis in the elderly: new issues for an old disease

Subcutaneously administered antibiotics: a national survey of current practice from the French Infectious Diseases (SPILF) and Geriatric Medicine (SFGG) society networks

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