Meropenem via PIV

[Groovydogg]

Hi all, I was wondering if there are any reasons not to administer meropenem via PIV in the home. My company refused a case because the pt did not have a picc or mid line. Another company picked the pt up with just the piv? pH seems acceptable and I can't find any obvious reasons why not, anyone have any ideas?

thanks!

[IVRUS, BSN, RN]

Meropenem has an excellent pH (It is between 5-9) and an osmolarity of around 300 with a 5mg/ml concentration. So, no, there is no reason why it can't go into a peripheral IV catheter. Perhaps the other agency is clueless about standards which delinieate what can, and cannot go peripherally.. But you aren't clueless.. Yay...

Now, is this a case where they thought the patient will consistently pull out a peripheral line.. if so, then I certainly wouldn't see them as a candidate for a midline or PICC. If the reason is because they have 6 weeks of meropenem, then I get that too, as most people, especially the elderly won't have six weeks of vascular access to cannulate q 3-4 days, depending on policy.

[iluvivt, BSN, RN]

Yes I agree with IVRUS as usual. This happens all the time and has nothing to do with whether or not it CAN be given via a PIV because it most certainly can! It most likely has to to with the length of treatment prescribed or the quality of the patient's vasculture or both. We only accept a PIVs for abx if the patient needs only 3 days of abx treatment or 3 days remaining. It is very difficult to keep any given patient on their IV abx schedule in the home with PIVs as they of course infiltrate, leak and the vein gets irritated and by the time the call is placed and the nurse gets there they are already off their schedule,not to mention irritated. It is also expensive to pay for the nursing visits and the same nurses that have worked all day must now go out often in the middle of the night to start a PIV. It also goes against some basic IV practices that promote venous preservation. An individual should not have to have a good portion of their veins destroyed because they need a few weeks of IV therapy.