IV infusion for 4 hours 8 hourly x 3 doses

Sour Lemon · Sep 3, 2017

Please I need your help.
A doctor prescribed and intravenous infusion to run for 4 hours 8 hourly x 3 doses. My question is, how many hours do I give in between the doses before commencing the next one. For instance if I give dose 1 at 10am and it runs till 2pm, when will I put up the next dose, is it by 6pm or 10pm.
A link to standard recommendations would be lovely to have too. Thank you.

Sounds like Zosyn? We run ours starting at 0600, 1400 and 2200 ...all up to one hour before or one hour after the due time. The end time is not significant.

MunoRN, RN · Sep 3, 2017

Typically that means each dose is started every 8 hours, it doesn't really matter how long it infuses for. If you want to take into account when the infusion ends, then you would still start the infusion every 8 hours so that the end of the infusions would also be 8 hours apart.

Guest219794 · Sep 3, 2017

Please I need your help.
A doctor prescribed and intravenous infusion to run for 4 hours 8 hourly x 3 doses. My question is, how many hours do I give in between the doses before commencing the next one. For instance if I give dose 1 at 10am and it runs till 2pm, when will I put up the next dose, is it by 6pm or 10pm.
A link to standard recommendations would be lovely to have too. Thank you.

I am not sure there is a link to standard recommendations. The duration of the infusion isn't part of the timing- that is just standard practice.

Look at it this way:

Nafcillin, 2g, Q4.

The infusion lasts 30 minutes.

06, 10, 14.....

If you were to take into account infusion duration times, it would be:

06, 1030, 15......

And that's not how it is done.

Also- as mentioned earlier, this sounds like Zosyn.

The rationale for this method of infusing Zosyn is that it maintains therapeutic levels with fewer doses. Less peak/trough effect. If you were to wait 8 hours between infusions, levels would drop. And scheduling it would be a nightmare.

In an aside: After speaking with our pharmacist, I learned that this is a cost saving measure, not an increase in therapeutic value. But, I think it is shortsighted, and that there are added expenses as well as inconvenience associated with 4 hour infusions. Extra lines for incompatible meds, extra time trouble shooting pumps, etc.. And think of it from a pt perspective- an extra 10 hrs a day hooked to a running line.