title: [Intramuscular route for the administration of the anti-flu vaccine in patients receiving oral anticoagulation therapy].
abstract: OBJECTIVE
  Comparison of safety and effectiveness of the intramuscular (IM) (deltoid) vs subcutaneous (s.c.) administration of the flu vaccine (FV) in patients on oral anticoagulation therapy.
  
  
  METHODS
  It was a phase IV, simple blind, 2-parallel groups, randomized trial developed in an urban primary care setting. We included patients taking oral anticoagulation therapy without FV contraindications. The IM administration of the FV in the experimental group was compared with a SC administration in the control group.
  
  
  RESULTS
  59 patients were included. The two groups were comparable at the beginning of the study. INR was not modified following s.c. (p = 0.38) or i.m. (p = 0.49) administration. No systemic side effects were observed. More cutaneous lesions were observed in the S.C. group (71.4%) when compared with the i.m. group (25.8%; p < 0.0001). For the remaining variables, we observed a tendency towards more reported pain in the SC group (35.7 vs 22.6%) and a larger brachial diameter (42 vs 29%) without significant differences. 3.2% of patients in the i.m. group and 7.1% in the s.c. group developed influenza symptoms without significant differences.
  
  
  CONCLUSIONS
  Even though the results must be interpreted with caution, currently there appears to be no apparent contraindication for the i.m. administration of the FV. When it is administered subcutaneously, it tends to cause more side effects.
authors.affiliation: EAP Ramon Turró, Barcelona, Spain.
authors.forename: María del Mar
authors.initials: Mdel M
authors.lastname: Ballester Torrens
authors.forename: Miriam
authors.initials: M
authors.lastname: Aballí Acosta
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Maudos Pérez
authors.forename: Begoña
authors.initials: B
authors.lastname: Iglesias Pérez
authors.forename: Josep
authors.initials: J
authors.lastname: Casajuana Brunet
authors.forename: Gustavo
authors.initials: G
authors.lastname: Losada Doval
authors.forename: María del Mar
authors.initials: Mdel M
authors.lastname: Piqueras Garré
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007273:Injections, Intramuscular; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method
chemical_list: D000925:Anticoagulants; D007252:Influenza Vaccines