[Antibiotics given subcutaneously to elderly]

Abstract

Aim: To find out data of antibiotics efficiency and tolerance given subcutaneously (SC) to elderly.

Method: A literature review based on subcutaneous route of antibiotic has been done in PubMed and Cochrane Library.

Results: Seventeen studies about ten antibiotics have been selected. According to HAS recommendations, methodology of these articles is poor: 3 are level B and 14 level C. Only amikacin, ceftriaxon and thiamphenicol have an official mention about SC route. Our literature review indicates that other antibiotics have been injected by SC route sometimes with local complication: gentamicin, netilmicin, tobramycin, sisomicin, cefepim, ampicillin, teicoplanin and ertapenem. Aminoside SC administration seems to be contra-indicated in clinical practice because of skin necrosis. However for other antibiotics, studies reveal poor evidence-based medicine and non specific geriatric patient inclusion. For these reasons, SC route for elderly isn't recommended.

Conclusion: Antibiotics given SC are little documented despite the great interest for elderly. Reasons of administration are often non official mention engaging prescriber responsibility.