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Review
. 2024 Jan 29;16(1):93-104.
doi: 10.3390/idr16010007.

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

Gabriele Maria Leanza  1 , Beatrice Liguoro  1 , Simone Giuliano  2 , Chiara Moreal  3 , Luca Montanari  3 , Jacopo Angelini  4 , Tommaso Cai  5   6 , Rita Murri  1   7 , Carlo Tascini  2   3
Affiliations
Review

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

Gabriele Maria Leanza et al. Infect Dis Rep. .

Abstract

The subcutaneous (s.c.) route is a commonly used method for delivering various drugs, although its application in the administration of antibiotics is relatively uncommon. In this case, we report a successful treatment of nosocomial pneumonia using piperacillin/tazobactam via continuous subcutaneous administration. Furthermore, this article provides an overview of the current literature regarding the s.c. administration of beta-lactam antibiotics. Based on our analysis, we identified only 15 studies that described the s.c. use of beta-lactam antibiotics in human subjects. Among these studies, cephalosporins were the most extensively investigated antibiotic class, with 10 available studies. According to the study findings, all three antibiotic classes (cephalosporins, penicillins, and carbapenems) demonstrated a similar pharmacokinetic profile when administered via the subcutaneous route. The subcutaneous route appears to be associated with a lower peak serum concentration (Cmax) but a comparable minimum blood concentration (Cmin) and an extended half-life (t1/2) when compared to conventional routes of antibiotic administration. Further research is necessary to determine whether subcutaneously administered beta-lactam antibiotics in human subjects achieve pharmacodynamic targets and demonstrate clinical efficacy.

Keywords: PK/PD; beta-lactams; subcutaneous administration.

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Conflict of interest statement

C.T. has received funds for speaking at a symposia organised on behalf of Pfizer, Novartis, Merck Gilead, Zambon, Infectopharm, Shionogy, Menarini, Angelini and Astellas. The other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Venflon 20 Gauge catheter used for piperacillin/tazobactam s.c. infusion (picture taken at the end of the infusion).
See this image and copyright information in PMC

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