Gent

We rarely use Gent anymore, only if they really need it. Doesn't the Neofax say 4mg/kg q 24 hour for term babies, and q 48 hours for premies, and give over 30 minutes?

That meant to us that a premie would barely get two doses before it was d/c'd. As we did levels around the third dose, they didn't often get levels. Now we usually use Amp and Claforan. We now have hospitalists, and have had lots of changes in the last couple of years.

I like to push the amp, especially on a PIV. I get a feel for the IV site, if it was good last night, and tonight it's slow, I'll replace the PIV before I give the meds.

Thanks to all of you who've answered! We're following the new guidelines for gent and get the peak after the first dose and adjust dosing times based on that and the trough before the second. I think the biggest problem is the nurses not documenting the amount of fluid given, with some of our peanuts, the volume of both a diluted gent and amp have to be taken into consideration. i.e for a 1280 grammer. Probably sounds HUGE for those of you that deal with the micros! :chuckle

One of our ped groups gives amp and gent with the gent given every 24 hrs and they say there is no need for P&T with this schedule. The amp we can push and it is diluted to 25mg/ml and the gent is given over 30 mins at a 2mg/ml dilultion.

Of course most of our babes are > 2000 gms.