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Published on: November 9, 2016
Approach to subcutaneous infusions in primary care: Indications, practical considerations, acceptability, and
Robin Arcani1, Julia George2, Florian Correard3
1Internist physician at la Timone, University Hospital of Marseille in France, and Associate Professor of Therapeutics at Aix-Marseille University.
Summary
Subcutaneous (SC) infusions, or hypodermoclysis, offer a safe and practical alternative to intravenous (IV) therapy, especially for elderly or frail patients in primary care settings. This method is less invasive, better tolerated, and associated with fewer complications than IV infusions.
Area of Science:
- Geriatrics
- Primary Care Medicine
- Pharmacology
Background:
- Subcutaneous (SC) infusions, also known as hypodermoclysis, are an established method for fluid and medication administration.
- While historically used, hypodermoclysis has seen renewed interest as an alternative to intravenous (IV) therapy in various clinical settings.
Purpose of the Study:
- To provide updated and practical guidelines for the use of subcutaneous (SC) infusions in primary care.
- To highlight hypodermoclysis as a viable alternative to IV infusions, particularly for specific patient populations.
Main Methods:
- A comprehensive literature review of the MEDLINE database was performed.
- Articles published from 1945 to 2025 were analyzed, with a focus on evidence levels II and III.
Main Results:
- Hypodermoclysis is less invasive, better tolerated, and easier to implement than IV infusions, with a lower risk of serious complications.
- Pharmacokinetic data show slightly slower absorption but often >80% bioavailability for hydrosoluble drugs.
- Key indications include dehydration, palliative care, and administration of specific antibiotics (e.g., ceftriaxone, ertapenem), furosemide, levetiracetam, vitamin B12, and certain vaccines.
Conclusions:
- Hypodermoclysis is a safe and practical alternative to IV infusion, especially for older or frail patients in home or nursing home settings.
- It addresses challenges in outpatient care and hospital overcrowding.
- Wider adoption requires enhanced professional training, standardized protocols, and more comparative evidence.
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