Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review
Most antimicrobial drugs need an intravenous (IV) administration to achieve maximum efficacy against target pathogens. IV administration is related to complications, such as tissue infiltration and thrombo-phlebitis. This systematic review aims to provide practical recommendations about diluent, pH,...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/8/1338 |
| _version_ | 1797585778579079168 |
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| author | Fabio Borgonovo Massimiliano Quici Antonio Gidaro Davide Giustivi Dario Cattaneo Cristina Gervasoni Maria Calloni Elena Martini Leyla La Cava Spinello Antinori Chiara Cogliati Andrea Gori Antonella Foschi |
| author_facet | Fabio Borgonovo Massimiliano Quici Antonio Gidaro Davide Giustivi Dario Cattaneo Cristina Gervasoni Maria Calloni Elena Martini Leyla La Cava Spinello Antinori Chiara Cogliati Andrea Gori Antonella Foschi |
| author_sort | Fabio Borgonovo |
| collection | DOAJ |
| description | Most antimicrobial drugs need an intravenous (IV) administration to achieve maximum efficacy against target pathogens. IV administration is related to complications, such as tissue infiltration and thrombo-phlebitis. This systematic review aims to provide practical recommendations about diluent, pH, osmolarity, dosage, infusion rate, vesicant properties, and phlebitis rate of the most commonly used antimicrobial drugs evaluated in randomized controlled studies (RCT) till 31 March 2023. The authors searched for available IV antimicrobial drugs in RCT in PUBMED EMBASE<sup>®</sup>, EBSCO<sup>®</sup> CINAHL<sup>®,</sup> and the Cochrane Controlled Clinical trials. Drugs’ chemical features were searched online, in drug data sheets, and in scientific papers, establishing that the drugs with a pH of <5 or >9, osmolarity >600 mOsm/L, high incidence of phlebitis reported in the literature, and vesicant drugs need the adoption of utmost caution during administration. We evaluated 931 papers; 232 studies were included. A total of 82 antimicrobials were identified. Regarding antibiotics, 37 reach the “caution” criterion, as well as seven antivirals, 10 antifungals, and three antiprotozoals. In this subgroup of antimicrobials, the correct vascular access device (VAD) selection is essential to avoid complications due to the administration through a peripheral vein. Knowing the physicochemical characteristics of antimicrobials is crucial to improve the patient’s safety significantly, thus avoiding administration errors and local side effects. |
| first_indexed | 2024-03-11T00:10:54Z |
| format | Article |
| id | doaj.art-c523eb13e4c744069170429bac3f0819 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T00:10:54Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-c523eb13e4c744069170429bac3f08192023-11-19T00:00:14ZengMDPI AGAntibiotics2079-63822023-08-01128133810.3390/antibiotics12081338Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic ReviewFabio Borgonovo0Massimiliano Quici1Antonio Gidaro2Davide Giustivi3Dario Cattaneo4Cristina Gervasoni5Maria Calloni6Elena Martini7Leyla La Cava8Spinello Antinori9Chiara Cogliati10Andrea Gori11Antonella Foschi12Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, ItalyInternal Medicine Unit, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, ItalyInternal Medicine Unit, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, ItalyEmergency Department and Vascular Access Team ASST Lodi, 26900 Lodi, ItalyUnit of Clinical Pharmacology, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, ItalyInternal Medicine Unit, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, ItalyInternal Medicine Unit, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, ItalyInternal Medicine Unit, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, ItalyInternal Medicine Unit, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, ItalyDepartment of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, ItalyMost antimicrobial drugs need an intravenous (IV) administration to achieve maximum efficacy against target pathogens. IV administration is related to complications, such as tissue infiltration and thrombo-phlebitis. This systematic review aims to provide practical recommendations about diluent, pH, osmolarity, dosage, infusion rate, vesicant properties, and phlebitis rate of the most commonly used antimicrobial drugs evaluated in randomized controlled studies (RCT) till 31 March 2023. The authors searched for available IV antimicrobial drugs in RCT in PUBMED EMBASE<sup>®</sup>, EBSCO<sup>®</sup> CINAHL<sup>®,</sup> and the Cochrane Controlled Clinical trials. Drugs’ chemical features were searched online, in drug data sheets, and in scientific papers, establishing that the drugs with a pH of <5 or >9, osmolarity >600 mOsm/L, high incidence of phlebitis reported in the literature, and vesicant drugs need the adoption of utmost caution during administration. We evaluated 931 papers; 232 studies were included. A total of 82 antimicrobials were identified. Regarding antibiotics, 37 reach the “caution” criterion, as well as seven antivirals, 10 antifungals, and three antiprotozoals. In this subgroup of antimicrobials, the correct vascular access device (VAD) selection is essential to avoid complications due to the administration through a peripheral vein. Knowing the physicochemical characteristics of antimicrobials is crucial to improve the patient’s safety significantly, thus avoiding administration errors and local side effects.https://www.mdpi.com/2079-6382/12/8/1338antimicrobialsantifungalsantiprotozoalsantiviralsantimycoticsantibiotics |
| spellingShingle | Fabio Borgonovo Massimiliano Quici Antonio Gidaro Davide Giustivi Dario Cattaneo Cristina Gervasoni Maria Calloni Elena Martini Leyla La Cava Spinello Antinori Chiara Cogliati Andrea Gori Antonella Foschi Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review Antibiotics antimicrobials antifungals antiprotozoals antivirals antimycotics antibiotics |
| title | Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review |
| title_full | Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review |
| title_fullStr | Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review |
| title_full_unstemmed | Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review |
| title_short | Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review |
| title_sort | physicochemical characteristics of antimicrobials and practical recommendations for intravenous administration a systematic review |
| topic | antimicrobials antifungals antiprotozoals antivirals antimycotics antibiotics |
| url | https://www.mdpi.com/2079-6382/12/8/1338 |
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