Administering Esomeprazole as a Continuous Subcutaneous Infusion in the Palliative Demographic: A Retrospective Review

To evaluate the safety, feasibility, and effectiveness of esomeprazole via continuous subcutaneous infusion, in palliative care patients unable to tolerate oral acid suppression therapy. A retrospective review of 92 prescriptions in 76 patients receiving 24-h esomeprazole via continuous subcutaneous infusion was undertaken. Electronic records were examined for dose, duration, infusion characteristics, site reactions, indications, and symptom outcomes. Across 637 treatment days, esomeprazole was well tolerated, only two patients developed injection site reactions (1%). Symptomatic benefit was observed in over 70% of cases for symptoms relating to dyspepsia, malignant bowel obstruction, and gastrointestinal bleeding. Esomeprazole as a continuous subcutaneous infusion appears safe, feasible, and clinically beneficial. Further prospective studies are warranted.