Safety and Pharmacokinetic Profiles of Subcutaneous Administration of Beta-Lactams: A Systematic Review

Beta-lactams are extensively used antibiotics known for their safety and effectiveness. The rise in patients who receive care in outpatient settings has increased the interest in subcutaneous administration (SA). The aim of the study is to assess the safety and pharmacokinetic (PK) profiles of SA of beta-lactams compared with other routes. The protocol was registered in the PROSPERO database and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Online databases were searched, and the quality of the eligible studies was assessed. The data extracted related to adverse events (AEs) and PK were summarised narratively. Sixteen studies were included. The reported AEs were generally mild, localised, and temporary. Although SA and intravenous administration had similar PK profiles, SA resulted in lower peak drug concentrations and slower absorption. Heterogeneity in the populations, medication delivery, outcome measures, and methodological quality emerged across the studies. The mild severity of AEs suggests that SA is a viable route. Additionally, SA appears to demonstrate effective PK profiles and delays drug release, with potential to reduce the dosing frequency and prolong the therapeutic effects. SA of beta-lactams is a promising viable alternative to intravenous administration, potentially enhancing treatment in the outpatient and long-term care settings.