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It is particularly advantageous for patients with poor venous access, frail or cachectic individuals, and in outpatient or palliative care settings, when oral options are not feasible. Subcutaneous delivery of antibiotics with predominantly time-dependent activity, particularly \u03b2-lactams (eg ceftriaxone, ertapenem) and glycopeptides (teicoplanin), allows attainment of therapeutic pharmacokinetic\/pharmacodynamic (PK\/PD) targets comparable to intravenous administration, while maintaining stable concentrations and reducing catheter-related complications. By contrast, PK\/PD benefits are limited for agents with more concentration-dependent activity, such as aminoglycosides and fluoroquinolones due to reduced peak levels and local toxicity, whereas daptomycin shows favorable exposure and target attainment with acceptable tolerability. Available evidence suggests good tolerability, although regulatory frameworks remain limited. This multidisciplinary review, authored by infectious disease specialists, clinical pharmacologists, and nurses, summarizes current clinical experience, PK\/PD data, and technical aspects of subcutaneous infusion.<\/jats:p>","DOI":"10.1093\/cid\/ciaf691","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T13:16:53Z","timestamp":1765372613000},"page":"e662-e673","source":"Crossref","is-referenced-by-count":4,"title":["When and How to Use Subcutaneous Antibiotics"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6121-7009","authenticated-orcid":false,"given":"Stefano","family":"Di Bella","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Trieste University Hospital (ASUGI) , Trieste ,","place":["Italy"]},{"name":"Clinical Department of Medical, Surgical and Health Sciences, Trieste University , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7988-5419","authenticated-orcid":false,"given":"Nicholas","family":"Geremia","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Infectious Diseases Unit, Ospedale \u201cdell'Angelo\u201d , Venice ,","place":["Italy"]},{"name":"Department of Clinical Medicine, Infectious Diseases Unit, Ospedale Civile \u201cS.S. Giovanni e Paolo\u201d , Venice ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6966-7167","authenticated-orcid":false,"given":"Federico","family":"Pea","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna , Bologna ,","place":["Italy"]},{"name":"Department for Integrated Infectious Risk Management, Clinical Pharmacology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Zeitlinger","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna , Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Sanson","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Health Science, University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8577-706X","authenticated-orcid":false,"given":"Jacopo","family":"Monticelli","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Trieste University Hospital (ASUGI) , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1224-9036","authenticated-orcid":false,"given":"Felix","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna , Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7677-3323","authenticated-orcid":false,"given":"Christian","family":"Motet","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles , Brussels ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Lambotte-Buffet","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles , Brussels ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9204-032X","authenticated-orcid":false,"given":"Verena","family":"Zerbato","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Trieste University Hospital (ASUGI) , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3018-3779","authenticated-orcid":false,"given":"Milo","family":"Gatti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna , Bologna ,","place":["Italy"]},{"name":"Department for Integrated Infectious Risk Management, Clinical Pharmacology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"2026043013141037400_ciaf691-B1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1093\/jac\/dkae398","article-title":"Safety, tolerability and pharmacokinetics of subcutaneous meropenem as an alternative to intravenous administration","volume":"80","author":"Murray","year":"2025","journal-title":"J Antimicrob Chemother"},{"key":"2026043013141037400_ciaf691-B2","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1177\/10499091231156866","article-title":"Effectiveness of subcutaneous administration of antibiotics to control infections in elder palliative patients: a systematic review","volume":"40","author":"S\u00e1nchez-C\u00e1rdenas","year":"2023","journal-title":"Am J Hosp Palliat Care"},{"key":"2026043013141037400_ciaf691-B3","doi-asserted-by":"crossref","first-page":"3546","DOI":"10.1093\/jac\/dkz385","article-title":"Is the subcutaneous route an alternative for administering ertapenem to older patients? 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