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Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review

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Title: Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review
Authors: 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
Source: Antibiotics, Vol 12, Iss 8, p 1338 (2023)
Publisher Information: MDPI AG, 2023.
Publication Year: 2023
Collection: LCC:Therapeutics. Pharmacology
Subject Terms: antimicrobials, antifungals, antiprotozoals, antivirals, antimycotics, antibiotics, Therapeutics. Pharmacology, RM1-950
More Details: 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®, EBSCO® CINAHL®, 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 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.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2079-6382
Relation: https://www.mdpi.com/2079-6382/12/8/1338; https://doaj.org/toc/2079-6382
DOI: 10.3390/antibiotics12081338
Access URL: https://doaj.org/article/c523eb13e4c744069170429bac3f0819
Accession Number: edsdoj.523eb13e4c744069170429bac3f0819
Database: Directory of Open Access Journals
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  Data: Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review
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  Data: <searchLink fieldCode="AR" term="%22Fabio+Borgonovo%22">Fabio Borgonovo</searchLink><br /><searchLink fieldCode="AR" term="%22Massimiliano+Quici%22">Massimiliano Quici</searchLink><br /><searchLink fieldCode="AR" term="%22Antonio+Gidaro%22">Antonio Gidaro</searchLink><br /><searchLink fieldCode="AR" term="%22Davide+Giustivi%22">Davide Giustivi</searchLink><br /><searchLink fieldCode="AR" term="%22Dario+Cattaneo%22">Dario Cattaneo</searchLink><br /><searchLink fieldCode="AR" term="%22Cristina+Gervasoni%22">Cristina Gervasoni</searchLink><br /><searchLink fieldCode="AR" term="%22Maria+Calloni%22">Maria Calloni</searchLink><br /><searchLink fieldCode="AR" term="%22Elena+Martini%22">Elena Martini</searchLink><br /><searchLink fieldCode="AR" term="%22Leyla+La+Cava%22">Leyla La Cava</searchLink><br /><searchLink fieldCode="AR" term="%22Spinello+Antinori%22">Spinello Antinori</searchLink><br /><searchLink fieldCode="AR" term="%22Chiara+Cogliati%22">Chiara Cogliati</searchLink><br /><searchLink fieldCode="AR" term="%22Andrea+Gori%22">Andrea Gori</searchLink><br /><searchLink fieldCode="AR" term="%22Antonella+Foschi%22">Antonella Foschi</searchLink>
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  Data: Antibiotics, Vol 12, Iss 8, p 1338 (2023)
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  Data: MDPI AG, 2023.
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  Data: <searchLink fieldCode="DE" term="%22antimicrobials%22">antimicrobials</searchLink><br /><searchLink fieldCode="DE" term="%22antifungals%22">antifungals</searchLink><br /><searchLink fieldCode="DE" term="%22antiprotozoals%22">antiprotozoals</searchLink><br /><searchLink fieldCode="DE" term="%22antivirals%22">antivirals</searchLink><br /><searchLink fieldCode="DE" term="%22antimycotics%22">antimycotics</searchLink><br /><searchLink fieldCode="DE" term="%22antibiotics%22">antibiotics</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%2E+Pharmacology%22">Therapeutics. Pharmacology</searchLink><br /><searchLink fieldCode="DE" term="%22RM1-950%22">RM1-950</searchLink>
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  Data: 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®, EBSCO® CINAHL®, 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 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.
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        Value: 10.3390/antibiotics12081338
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      – SubjectFull: antifungals
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