No more piggybacking zosyn?

Jenni811, RN · May 25, 2012

That doesn't make sense to me either. Do they want you running it as a primary then?

blondy2061h, MSN, RN · May 25, 2012

We still piggyback it. Also curious how they want you to run it.

RENEfromLA · May 25, 2012

Yeah they want us to use it as a primary...so for instance if we already had a primary just get a double primary pump...

classicdame, MSN, EdD · May 25, 2012

ask the pharmacist.

CharlieTaco · May 25, 2012

Zoysn is supposed to be run over a four hour period. This is a new policy since most people used to run it as a rapid infusion 15-30mins. If your running it over 4 hours twice a day, what ever fluid is on the primary line would now be paused for a total of at least 8 hours a day.

Jenni811, RN · May 25, 2012

well it makes since if you have maintenance fluids running, but if you don't then you need to run it piggy-back so all of it gets in. We still infuse over 30 minutes. Since when does it go over 4 hours?

Jenni811, RN · May 25, 2012

Ok- i had to look this up. Giving it slower (4 hrs) makes it stay in the system longer. Some hospitals will do zosyn over 30 minutes but will do it more freqeuntly (i.e. every 6 hours). So if you are giving zosyn over 4 hours...you probably only have to do it 2xday. If you run it in 30min, then you have to do it more frequently...either every 6 or every 8 hours.

Esme12, ASN, BSN, RN · May 25, 2012

There are new studies that Zosyn is more effective if given over an extended peroid of time every eight hours therefore it is no longer a "piggyback"but a continous infusion.

http://www.nebraskamed.com/App_Files/pdf/careers/education-programs/asp/pip-tazoEI-protocol-detail.pdf

http://www.rsfh.com/portal/RSFHEIZosynMDeducationfirstpage.pdf

nursynurseRN · May 25, 2012

WOW!! never heard of that!!

MunoRN, RN · May 25, 2012

While it's given over a longer period of time, it's still an intermittent infusion. Our policy is to still use a primary "flush bag" although we use one that's separate from whatever IVF are running. We run the infusion continuously at 12.5 ml/hr and hang a 50 cc bag of zosyn every 4 hours, with the "flush bag" NS running in between.

We initially were running it as a primary but found too much zosyn was being wasted priming the bag and then removing air if the drip chamber emptied between doses (at times about 20cc was being wasted, or almost half the dose). Setting it up as a secondary allows for the NS to be wasted in the sink rather than the zosyn and keeps the line primed between doses rather than setting the pump volume low so that you don't suck the bag dry, or emptying the bag which causes more waste of antibiotic when you re-prime the line.

redhead_NURSE98!, ADN, BSN · May 25, 2012

There are new studies that Zosyn is more effective if given over an extended peroid of time every eight hours therefore it is no longer a "piggyback"but a continous infusion.
http://www.nebraskamed.com/App_Files/pdf/careers/education-programs/asp/pip-tazoEI-protocol-detail.pdf
http://www.rsfh.com/portal/RSFHEIZosynMDeducationfirstpage.pdf

Thank you!! At my old hospital it could not be piggybacked and was to run in at 25/hr, and no one could ever state any rationale for this and I couldn't find any. Where I work now it's piggybacked and given q6 at 100/hr.