Gent

I've noticed many level I and II nursery nurses diluting gent that way. No one I know in a level III does because we're so concerned about fluid overload. I'm guessing that they give a more diluted gent in the lower level nurseries to prevent irritation and side effects, since they usually work more with peripheral IVs. Just a guess...

We don't dilute it at all, give it straight 10mg/ml over 30 minutes. We don't give a 30 minute flush afterwards, but I think we should if it's a heplock with no other running fluids, instead of just flushing it SIVP. Usually it's into a running line though, so the maintenance fluids just carry the med in.

Dear Gompers, thanks, I was taught never to give any extra fluids esp. with resp distress. I prime the med line with the gent, and then follow with a 0.6 ml flush. A new grad orienting in the unit asked me if the 6ml dilution was correct. Thanks again!

We dilute it to equal what 30 minutes of their main iv infusion would be. (sorry bad wording) For example if baby had d10w at 10 cc and hour then we dilute it with 5 cc of d10w and run it over 30 minutes, and put the main IV on hold for 30 minutes. We are a level 2. We have vents and CPAPs and some minor surguries but no ECMO major surgery stuff. More like a level 2.5 if there were such a thing

We dilute the Gent to 5mg/ml, and we push it. Our Amp is diluted to 30mg/ml. This is hospital wide for all of peds. if we need, we can have pharmacy make the meds more concentrated if fluids are a really big issue.

We dilute the Gent to 5mg/ml, and we push it. Our Amp is diluted to 30mg/ml. This is hospital wide for all of peds. if we need, we can have pharmacy make the meds more concentrated if fluids are a really big issue.

Really? You push Gent? I've only ever pushed Amp and it's usually after a delivery or if the kid is septic or has perforated a bowel.

I've also never diluted Gent. Most of our kids are on TPN and need those electrolytes.

Nope..new guidelines. We use postconceptual age and weight and we only dose qd, q36h or q48h. We also check the levels at the second dose to make sure we are therapeutic. It is believed that the gent's ototoxicity is related to the levels and length of treatment.

Nope..new guidelines. We use postconceptual age and weight and we only dose qd, q36h or q48h. We also check the levels at the second dose to make sure we are therapeutic. It is believed that the gent's ototoxicity is related to the levels and length of treatment.

That's interesting. We start at Q18 and adjust up or down acording to the third dose peak and trough. Do you have an article I could read?

That's interesting. We start at Q18 and adjust up or down acording to the third dose peak and trough. Do you have an article I could read?

Our new testing includes peak after the first dose and trough before the second. Interesting... Our gent always runs over 30 minutes and doesn't get further diluted.

Rainbows

We dilute our Gent to 5 mg/ml and give it over 30 minutes on a pump. We never push it. We give Amp over 15 minutes on a pump (100 mg/ml dilution).

Our near-term and term babies start Gent at q18h and get Peak and Trough around the 3rd dose. Our preemies start at q24h and get Peak and Trough around the second dose if they need Gent; we start them on Claforan first since it is less toxic and easier on their kidney function than Gent and then start Gent if a culture shows the baby really needs the Gent.

We use Gent pretty often, I have to say. Most of our new admits get put on Amp and Gent, plus it's the combo the docs usually order for babies down the road when they're suddenly acting septic. They usually don't deviate from that unless the baby has a positive culture indicating different antibiotic needs, or if the baby is exibiting signs of renal failure.

For full-term newborns, it's 4mg/kg of Gent Q24H.

For preemies, it's 2.5mg/kg of Gent Q24H.

We do peaks and troughs with the third dose if the plan is to keep the baby on antibiotics beyond those first three days. We'll go to Q36H dosing if the baby's Gent level is high.

We give the pre-made 10mg/ml solution over a pump for 30 minutes.

(Ampicillin - we give the 100mg/ml dilution slow IV push, but I agree that it's so irritating to their veins! I think we should further dilute it if we're giving through a peripheral IV - and usually the kinds of kids who need major fluid restrictions have central lines anyways, so wouldn't have to dilute their doses anyways...)