Antibiotics during dialysis

  1. Hi all. I am new to dialysis and have a question... I was wondering if any of you had any info on administering antibiotics while the pts are dialyzing. My clinic doesnt have a specific policy for each antibiotic....please help. Just wondering how and when during the treatment do you admin some of the most common antibiotics, such as vanco, gent and ancef. Thanks in advance.
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  2. 13 Comments

  3. by   kewlnurse
    I don't work in dialysis, but i did work on the renal ranch and we always gave the abx when they returned to the floor afer their dialysis
  4. by   CC NRSE
    i'm not a dialysis nurse either,... but work critical care. we always give post dialysis. those particular drugs are dialyzied out.
  5. by   3651bht
    I work in an outpatient setting and we give most of the antibiotics the last 45 -20 minutes of the treatment.. If possible to give after treatment i.e. in hospital environment that is ideal. But an outpatient will not stay to receive them as they have already been there > 4 hours... And yes most to them do dialyze out and that is why they are given as late as possible in the treatment.. We give them for the same amount of time that you give them in house..Cipro in the hospital 20 min Cipro in an outpatient setting 20 minutes..


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  6. by   nursefiggy
    We give vanc the last hr of tx over an hour. We push gent dilluted with saline over last 10 minutes of tx.
  7. by   jnette
    Originally posted by nursefiggy
    We give vanc the last hr of tx over an hour. We push gent dilluted with saline over last 10 minutes of tx.
    Ditto... except we push the gent or tobra over the last half hour of tx.
  8. by   mittels
    For most abx its the last 15" on tx unless it needs to be given over an hour, then the last hour. It really depends on whether the abx can be dialyzed off easily. If it is protein bound then yes, it will be and your safest measure is post tx
  9. by   Juanay
    In most of the chronic units I've worked in Vanc is given in the last hour, Ancef and Fortaz over last 30 min, Gent is given last 30 - 15 min with some nurses giving it IVP with the rinseback.I personally do not recommend it b/c of ototoxicity.
    Juanay
  10. by   nurse dolly
    Quote from TELEpathicRN
    Hi all. I am new to dialysis and have a question... I was wondering if any of you had any info on administering antibiotics while the pts are dialyzing. My clinic doesnt have a specific policy for each antibiotic....please help. Just wondering how and when during the treatment do you admin some of the most common antibiotics, such as vanco, gent and ancef. Thanks in advance.
    We used to give it last hr of dialysis at out clinic due to dialyzing out of antibiotics or gent was given last 15-30 mins. However our policy has changed and all antibiotics are now given after dialysis over 30 mins to an hour depending on which one this is our standard policy now, sure miss the old way but I work for RCG and these are their rules and I guess it is safer for the patient.

  11. by   Juanay
    :chuckle
    The unit I work in now still gives vanc over the last hour, but gives Ancef and Fortaz post tx because they dialyze out. This is an RCG unit too.
    Juanay
  12. by   Kathan
    Quote from TELEpathicRN
    Hi all. I am new to dialysis and have a question... I was wondering if any of you had any info on administering antibiotics while the pts are dialyzing. My clinic doesnt have a specific policy for each antibiotic....please help. Just wondering how and when during the treatment do you admin some of the most common antibiotics, such as vanco, gent and ancef. Thanks in advance.
    I am an RN in an outpatient hospital based dialysis unit for 8 years now. We have always given vancomycin the last hour of treatment. We have a vanco protocal. Kefzol, Gent the last 1/2 hour of treatment. We are considering IV push for the Kefzol .
  13. by   day2
    From an RCG unit Vanco last hour, Gent and Cipro 15-30mins post tx.
  14. by   kaffenoir
    Hi,
    I work in an acute care setting (hosp) and we have a chart which tells you which meds dialyze out. You can get them from the drug reps ie.. Pfizer etc..
    Nevertheless, Vancomycin should be given the last hour of the treatment, and gent should be given post dialysis only, as it dialyzes out. Pushing it during rinse back is contraindicated as it causes ototoxicity. As a matter of fact we just had a pt. that had ototoxicity from nurses pushing it. Gent should be given over 30-60 mins. Ancef and fortaz are also post tx. If you need more info, or a protocol pm me back.

    kaffenoir

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