大多数抗微生物药物需要静脉内(IV)施用以实现针对靶病原体的最大功效。静脉给药与并发症有关,如组织浸润和血栓静脉炎。本系统综述旨在提供有关稀释剂的实用建议。pH值,渗透压,剂量,输注速率,起泡剂特性,和在随机对照研究(RCT)中评估的最常用抗菌药物的静脉炎率,直至2023年3月31日。作者在PUBMEDEMBASE®的RCT中搜索了可用的IV抗菌药物,EBSCO®CINAHL®,和Cochrane对照临床试验.在网上搜索了药物的化学特征,在药物数据表中,在科学论文中,确定pH<5或>9,渗透压>600mOsm/L的药物,文献报道的静脉炎发病率高,和起泡药物在给药过程中需要采取最大的谨慎。我们评估了931篇论文;包括232项研究。总共鉴定了82种抗菌剂。关于抗生素,37达到“谨慎”标准,以及七种抗病毒药物,10种抗真菌药,和三种抗原生动物.在这个抗菌药物亚组中,正确选择血管通路装置(VAD)对于避免通过外周静脉给药引起的并发症至关重要.了解抗菌药物的理化特性对于显著提高患者的安全性至关重要,从而避免管理错误和局部副作用。
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 <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.