help in infusing bactrim

EricJRN, MSN, RN · Nov 20, 2006

I'm having some trouble understanding the 80-16 mg/mL part. Is that your dose on hand?

I don't think brand name Bactrim is available IV. You may want to use the generic if you turn in an assignment related to this.

P_RN, ADN, RN · Nov 20, 2006

Bactrim I.V. Drug Information

Bactrim/Septra is a combination drug containing:

Sulfadiazine and trimethoprim

Read up on the drug and let us know what you think would be your answer.

augigi, CNS · Nov 20, 2006

HOW SUPPLIED:

10-mL Vials, containing 160 mg trimethoprim (16 mg/mL) and 800 mg sulfamethoxazole (80 mg/mL) for infusion with 5% dextrose in water. Boxes of 10 (NDC 0004-1955-01).

30-mL Multidose Vials, each 5 mL containing 80 mg trimethoprim (16 mg/mL) and 400 mg sulfamethoxazole (80 mg/mL) for infusion with 5% dextrose in water.

Method of Preparation:

Bactrim IV Infusion must be diluted. EACH 5 ML SHOULD BE ADDED TO 125 ML OF 5% DEXTROSE IN WATER. After diluting with 5% dextrose in water the solution should not be refrigerated and should be used within 6 hours. If a dilution of 5 mL per 100 mL of 5% dextrose in water is desired, it should be used within 4 hours. If upon visual inspection there is cloudiness or evidence of crystallization after mixing, the solution should be discarded and a fresh solution prepared.

Multidose Vials: After initial entry into the vial, the remaining contents must be used within 48 hours.

Dilution: EACH 5 ML OF BACTRIM IV INFUSION SHOULD BE ADDED TO 125 ML OF 5% DEXTROSE IN WATER.

Note: In those instances where fluid restriction is desirable , each 5 mL may be added to 75 mL of 5% dextrose in water. Under these circumstances the solution should be mixed just prior to use and should be administered within 2 hours. If upon visual inspection there is cloudiness or evidence of crystallization after mixing, the solution should be discarded and a fresh solution prepared.

DO NOT MIX BACTRIM IV INFUSION-5% DEXTROSE IN WATER WITH DRUGS OR SOLUTIONS IN THE SAME CONTAINER.

Administration: The solution should be given by intravenous infusion over a period of 60 to 90 minutes. Rapid infusion or bolus injection must be avoided. Bactrim IV Infusion should not be given intramuscularly.

From: Bactrim Indications, Dosage, Storage, Stability - Trimethoprim and Sulfamethoxazole - RxList Monographs

So I would take from that :

* Your dose is 160mg (trimethoprim) IV every 6hrs

* So: 160mg (10mls solution) should be diluted in 250mls D5W, then infused over 60-90 mins.

Make sure you check the compatibilities on the package insert before piggybacking with other fluids etc.

Daytonite, BSN, RN · Nov 20, 2006

Bactrim is a combination drug that consists of sulfamethoxazole and trimethoprim. For IV infusion it comes in solutions consisting of 80mg of sulfamethoxazole and 16mg of trimethoprim per mL of the drug solution. This solution, based on the dose ordered, is generally mixed in 125 to 250cc's of D5W and infused as a piggyback. You will sometimes see the order for this written as:

Bactrim 16/80 in 125cc of D5W

Bactrim 32/160 in 250cc of D5W

SMX/TMP 16/80 in 125cc of D5W (abbreviation for the generic drugs)

SMX/TMP 32/160 in 250cc of D5W

It is compatible with all other IV solutions. I would strongly suggest that you infuse the piggyback of this medication over 90 minutes. Patients can sometimes get nauseated while this drug is infusing. If the patient complains of pain at the IV site or radiating up the limb that the IV is in, the IV site should be changed.

laurainri · Nov 20, 2006

thank you so much for the reply. when I got to clinicals this morning we added the bactrim to 500 ml of d5w because it was 16 mg. and it said for every 5 mg it sould be 125 ml of d5w. I appreciate all your help

augigi, CNS · Nov 20, 2006

You're welcome, although it actually says for 5 MLS (and not 5mg) of IV solution you should add 125mls - which would be a total of 250mls, since you were using 10mls of solution (160mg)