Administration of antibiotics subcutaneously: an integrative literature review

Objective: To characterize scientific articles related to the use of antibiotics by the subcutaneous route in patients with difficult venous access in palliative care, regarding local tolerance and therapeutic efficacy. Methods: Integrative literature review conducted in the databases of LILACS, CINAHL, PubMED, EMBASE and the Cochrane Library, using Evidence-Based Practice as a theoretical framework. Results: Seventeen articles were selected with ten different antibiotics, with ceftriaxone being the most studied antibiotic. Therapeutic efficacy was observed based on pharmacokinetic and clinical parameters. The local tolerance was associated with greater dilution of antibiotics. With administration of aminoglycosides, serious injuries and tissue necrosis were observed. A low tolerance reinforced the restriction of use only to this class of antibiotics. Conclusion: The predictions of therapeutic efficacy and good tolerance suggest a possibility to be considered when there is need of an alternative parenteral route of administration, but caution is advised, since none of the studies evaluated patients in palliative care.