Subcutaneous antibiotic therapy: effectiveness and safety in a real-world cohort of 136 patients

Subcutaneous antibiotic administration is increasingly considered an alternative to intravenous therapy in selected patients. It can facilitate early discharge and outpatient management when oral treatment is not possible.

We retrospectively evaluated the effectiveness and tolerability of subcutaneous ceftriaxone, teicoplanin, and ertapenem in adults treated in a university infectious diseases center between January 2017 and February 2023.

A total of 136 patients were included. The median age was 64 years (interquartile range 53-78), and 38% were older than 75 years. Bone and joint infections (45.6%), urinary tract infections (25.7%), and pulmonary infections (22.1%) were the most frequent indications. Overall clinical cure was achieved in 126/136 patients (92.6%). Cure rates reached 100% for urinary tract and cardiovascular infections and 96.7% for pulmonary infections. Twenty-one adverse events were reported, including injection site pain in 11 patients (8.1%). No severe local complication occurred. Teicoplanin trough concentrations, available in three patients with adverse events, remained within the therapeutic range.

These findings support subcutaneous ceftriaxone, teicoplanin, and ertapenem administration as a safe and effective alternative when oral or intravenous therapy is not feasible.