My question is going to seem very naive( trying to avoid the word stupid lol) but cant help but ask.

I dont work pediatrics and Dr ask me to given a 8month old infant dose of Ceftriaxone 500mg. I told him no b/c I dont do infants and dont feel comfortable with giving the dose. He say he is the Dr and if he says the dose is 500mg then its 500mg. I said still I dont feel comfortable

It kinda makes me feel like an idiot b/c I knew what he was saying is that its simple just draw up and reconstitute the drug with lidocaine like you do with adults but give the amount he says .

Well for you peds nurses dont laugh at me but did I do the right thing. Am I just being over cautious. 8month old was 23lbs

Just like to know your opinion and if you say I am being silly then at least its another nurse telling me and not the Doctor.

Cant tell you how many times physician have ordered the wrong dose on adults and b/c I reverfied what they where saying I did not give what they ordered mistake until they corrected the dose.

However, I dont know the pediatric doses for any of the meds

I dont work in the pediatric department there pediatric nurse was out.

I work upstairs in adult triage in the clinic

Just wanted to get your opinion.

Thanks Angela

Pediatric Critical Care Columnist / Guide

NotReady4PrimeTime, RN

16 Articles; 7,358 Posts

Specializes in NICU, PICU, PCVICU and peds oncology. Has 25 years experience.

The dose is appropriate for meningitis, and is at the maximum of the range for other serious infections. But you were right to question the order, because you don't work peds and you don't know usual doses. It's never wrong to look things up and verify them and in peds it's a standard of care that ALL doses of ALL meds be double checked to ensure the safety of the patient. In our hospital it doesn't matter which doctor is ordering the drugs or how smart they are or how long they've been practicing pediatrics, ALL doses are to be double-checked. Did you end up giving the ceftriaxone? We don't use it at all in our unit, going with cefotaxime instead, but kids coming in from rural hospitals might have had an IM dose for possible meningitis prior to our transport team's arrival.


263 Posts

No Doctor gave the dose.It was given for ear infection and temp 101F.

I do work in a hospital on a adult cardiac unit but I came in on that Sunday for triage in adult clinic only to cover a nurse that was out. I dont work at all in peds they have there own nurse in that department. Its a community clinic. They called me while I was working in the adult clinic to come to there peds clinic to give that dose to 8month old. I have given ceftriaxone at that same dose to adults. Didnt think 8month would get the same dose as an adult.

Thanks for your reply.............

Pediatric Critical Care Columnist / Guide

NotReady4PrimeTime, RN

16 Articles; 7,358 Posts

Specializes in NICU, PICU, PCVICU and peds oncology. Has 25 years experience.

Wow. Ceftriaxone for an ear infection in an outpatient with only a low-grade fever seems like overkill. Just MHO.


27 Posts

Specializes in transport,forensics,ED. Has 20 years experience.

Unfortunately we are the biggest culprits in the abundance of anti-biotic resistant organisms as we throw everything at nothing. The dose was correct, though the need may not have been there. Hard to arm chair quarterback without all the info, but I tend to challenge antx orders now that I never did before.


64 Posts

I may get flagged for this, and I don't mean this negatively, but that's a pretty routine peds order for us. If you were uncomfortable with it, than why were you in the position to cover for another nurse? You shouldn't have been covering for someone if you don't feel comfortable. Your license is on the line. That's just my honest opinion.


22 Posts

Specializes in med-surg, peds, ICU stepdown. Has 18 years experience.

we use ceftriaxone in our peds office if the pt fails 3 antibotic prescriptions. They recieve 1 dose QD X3 days, does the trick everytime.

Specializes in LPN, Peds, Public Health.

Seems like a usual dose to me, gave it all the time in peds, also had them given to my children when they had ear infections (oral just didnt do it) 500mg is what was usually given, unless it was a younger, smaller infant. I agree that if you dont feel comfortable doing it then you shouldnt do it. And I do have to say that it doesnt always work. At 10 months old my son had a 105 fever for a week straight and all they could find was an ear infection. During that time he had 3 500mg injections and no change. Wasnt long after that he got tubes put in! (he had about 13 ear infections in 11 months). Im all for it though, its works much faster than oral meds. And though the child may have only had a 101 fever in the office, that could have been with motrin and the child may have been running much higher at home.

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