Ampicillin/Cefotaxime in Febrile Neonate

prmenrs, RN · Dec 13, 2006

We just push them. DILUTE them--they're hard on the veins.

I'm moving your post to NICU forum where it can get more input.

LoveTheNICU · Dec 13, 2006

In my NICU, we run Amp over 5-10 minutes on a syringe pump, followed by a flush over 5 minutes. If the volume is less than 1 ml, some nurses will push the med very slowly and and run a flush over 5-10 minutes. Claforan (cefotaxime) we run over 10 minutes on a syringe pump as well. The only commonly used antibiotic we run over an hour is gentamicin, which we dilute with 2mls of sterile water (regardless of dose) and run over 60 minutes.

Gompers, BSN, RN · Dec 13, 2006

Every unit is going to have different ways of doing things, as we're seeing right here. It's best to call your hospital's pharmacy or pediatric unit to find out how they give the meds.

We give ampicillin slow IV push over a few minutes, followed by 0.5-1cc normal saline slow IV push. We dilute it with sterile water to make it 100mg/ml regardless of baby's age/size/type of IV.

Cefotaxime is diluted by the pharmacy for us - it used to be 100mg/ml but now they're doing it 40mg/ml. We give it on a syringe pump over 30 minutes.

RainDreamer, BSN, RN · Dec 13, 2006

We always dilute our amp 100 to 1 with sterile water. And then give it IV push, followed by some NS to flush it through the tube.

Cefotaxime comes up from pharmacy and we put that on the syringe pump ..... I don't remember how long because it's in the list of meds and it automatically sets the time, I think over 30 minutes or so.

preemieRNkate, RN · Dec 13, 2006

We get 500mg powder vials of ampicillin from pharmacy, which we dilute with 5ml sterile water to make it 100mg/ml. We then give it over 5-10 minutes on a syringe pump. Cefotaxime comes from pharmacy already mixed and ready to give, and I believe we give it over 30 minutes. Alot of the antibiotics we give are over 30 minutes, anything that isn't usually says so on the label from pharmacy or we call them and ask. We also use the Neofax to determine how long to give it over.

KRVRN, BSN, RN · Dec 13, 2006

Ampicillin 100mg/mL concentration... IVP over 3-5 min.

Cefotaxime 100mg/mL concentration... IV over 30 min.

BittyBabyGrower, MSN, RN · Dec 14, 2006

Our pharmacy makes them and we give both slow push.

lovemyjob · Dec 16, 2006

we give everything over 30 min except vancomycin which goes over 1 hr and ampho wich goes over 2hrs. there is another one that goes over 45 min....cant think of what it is. We use neofax to determine how fast to infuse. Gent def over 30 min. according to neofax, cefotaxime should go over the syringe pump for 30 min. Amp can be given over 3-5 min.

Do all hospitals not use neofax as their standard/policy for med admin?

luckylucyrn · Dec 17, 2006

I don't know about neofax. We don't have a lot of neonates come through our ED, so I haven't been exposed to a lot of problems they might have. We get febrile neonates, high bilirubin babies, and a lot of first time parents that just need some guidance and reassurance. Most of the neonates go to our main children's hospital in memphis. My hospital has a limited Pediatric service. I'm learning what I can from each case because I would like to go to NICU someday.

BittyBabyGrower, MSN, RN · Dec 17, 2006

Our pharmacy makes our med books up. They use several sources to come up with our guidelines, including neofax and the pediatric drug book.

danissa, LPN, LVN · Dec 22, 2006

Our most commom antib's are Benpen (3-5min push), Gentamicin (3-5 min push, Cefotaxime (3-5 min push) and Vanc over 1 hour. Also may use Fluclox as a push over 3-5 mins, we use benpen and gent as first line and prophylactic and the others for second line sepsis.

Have never given Cef as an infusion, only as a push!

Our pharmacy also makes up our antib's during the week, but we make them up for new admits or over the weekend.