Clinical evaluation of subcutaneous administration of cefepime

Abstract Objectives Cefepime is a fourth-generation cephalosporin active against Pseudomonas aeruginosa and most Enterobacteriaceae. Intravenous (IV) administration is the standard route of prescription. However, subcutaneous administration (SC) may represent an interesting alternative. We aimed to evaluate SC administration of cefepime versus the IV route in geriatric patients. Patients and methods Multicenter retrospective analysis in patients treated with cefepime by SC route who underwent plasma concentration monitoring. Results Twelve patients were included in the SC group and matched to 12 patients in the IV group. The median and mean Cmin levels were 29.05 mg/L [14.2–48.2]; 33.4 mg/L (± 21.8) in the SC group and 31.9 mg/L [26.5–51.7]; 39.6 mg/L (± 27) (P = NS) in the IV group. No local SC administration-related complications were reported. No relapse was observed over six months of follow up. Conclusion Subcutaneous use of cefepime seems to have the same clinical and microbiological effectiveness as parenteral administration.