is it okay to give all antibiotics at the same time?

[Tiar]

what i know is that you will base the timing of antibiotics on the time of your loading dose, if its tid then you' ll count from the time you first gave the abx,. but in my hospital they are stritcly following the standard time. for tid its 6-14-22, so if the loading time is 9am they will give the second dose at 14hrs... so tendency if there is three abx all will fall on the same time... in which i think, there should be a gap in giving antibitics,,

[loriangel14, RN]

Why do you think there needs to be a break? I currently have a patient wth 3 antibiotics @ 1400 today

[chare]

With the exception of post-operative antibiotics and certain antibiotics (e.g., aminoglycosides) we do something similar. Most PO antibiotics are scheduled BID, TID, or QID, with standard administration times for each frequency, with the first dose scheduled to be administered at the next standard administration time.

Intravenous antibiotics are scheduled q12 hours, q8 hours, or q6 hours with standard administration times for each. The first dose is scheduled for administration two hours after the order was written. For most antibiotics, timing of the next dose depends on time to first standard administration time. If the time to the next with the first standard dose is greater than 50% of the dosing interval, the next dose will be scheduled for the first standard administration time. If the to the first next standard administration time is less than 50% of the dosing interval, the next dose will be scheduled for the second standard administration time. For some antibiotics (e.g., aminoglycosides), the second dose is scheduled based upon the actual administration time of the first dose.

[Double-Helix, BSN, RN]

Without supporting research, the only potential problems I could think of are if the antibiotics are either particularly vaso-irritant or nephrotoxic. Back to back vaso-irritants may increase the risk of IV complications from phlebitis, infiltration, etc. Nephrotoxic medications administered without breaks may increase stress on the kidneys.

[Tiar]

thanks, same here that's what i know, the second dose depends on the time you first administer it, i asked this question coz of my colleagues, i'm working in adult icu, and were giving strong abx to our patients, our standard time if its tid is 6-14-22, case in point was, loading dose was 9 am, so 2nd dose should be 5pm, but instead my senior will give the next dose at 3pm and then 10 pm, so that it will still fall according to the standard time.,, which i think is wrong,. i kept arguing with my senior that correct timing in giving abx should be done., and also i noticed in their practice is that in 24 hrs patient should receive the total dose per day,for eg, colistin 3million tid, for this day patient only received 2 doses because of some circumstances like patient was dialyzed, so after dialysis abx should be administered, and then before end of the day even if its not yet 8hrs gap from the 2nd dose, they will again give the 3rd dose so that the patient will still receive the 3 doses per day.