Running an IV ABX at a slow rate, does this do much harm?

[CaLLaCoDe, BSN, RN]

I have been known to run IV antibiotics at a slow rate for a diverse population of patients: a lady in her eighties with CHF to receive a 250ml piggyback at 250ml (too much fluid IMHO) and a renal patient recently complained of the rate of fluid entering her was hurting at the IV site. Slowing the rate down did nullify the pain for my renal patient. I called for IV therapy to try starting a new site. I was dumbfounded when IV therapy showed up: the patient denied the necessity of having a new site, adamantly stating that a new site was unnecessary.

Anyway, back to my query, is it entirely out of the question to run an Abx at a slow rate??? Does doing this lower the potency of the medicine?

[jeepgirl, LPN, NP]

some antibiotics need to run in at a certain rate to reach a theraputic concentration in the blood stream / body. i would run at the recommended rates unless your supervising provider says otherwise OR someone who has authority and who is supervising - for instance, a Pharm D who is monitoring administration - says to slow down administration rates.

[suzanne4, RN]

It should always be run at the rate that is listed on the IVBP unless there is specific reason or order not to. Running one IVPB at 250 ml/hr is not going to put anyone into failure. But the patient could run into more issues if they do not have enough of the antibiotic in their system to meet the trough requirements. And if you run it in slower, then they run the risk of getting overdosed as the dosing is based on it infusing at the rate that the pharmacy requests.

If the physician had specific concerns about the volume, they can always order for the IVPBs to be concentrated, etc.; or run in the minimum amount of fluid.