Timing of antibiotics

Published

  • Specializes in Babies, peds, pain management. Has 31 years experience.

I was always taught to give ampicillin first then gentamicin 2 hours late to avoid incompatiability. Is this still the way it is done? Thanks for your help.

NicuGal, MSN, RN

2,743 Posts

Specializes in NICU, PICU, PACU. Has 30 years experience.

We give Amp first because it is a faster infusion time then Gent right after. We flush in between so the meds are separated.

katierobin23

147 Posts

We give Amp first because it is a faster infusion time then Gent right after. We flush in between so the meds are separated.

Ditto

Our unit also stocks Amp in the Pyxis while Gent has to come up from pharmacy, so that's another reason the Amp gets administered first.

SteveNNP, MSN, NP

2 Articles; 2,512 Posts

Specializes in Neonatal ICU (Cardiothoracic). Has 9 years experience.

Ampicillin is safe to give slow push, then flushed and gent is placed on a syringe pump. They are incompatible if mixed in the same syringe or given at a Y-site together. Giving them back to back is not a big deal. IMHO it's better to get both gram + and gram - coverage onboard ASAP when a kid comes in sick.

Bortaz, MSN, RN

1 Article; 2,628 Posts

Specializes in CDI Supervisor; Formerly NICU. Has 14 years experience.
Ampicillin is safe to give slow push, then flushed and gent is placed on a syringe pump. They are incompatible if mixed in the same syringe or given at a Y-site together. Giving them back to back is not a big deal.

I had intended to say the very same thing as you posted, but got busy and forgot.

NICURN29

188 Posts

Specializes in NICU. Has 11 years experience.

Our first doses of amp and gent are profiled at the same time, soon after admission. And we usually choose to give the amp first due to the quicker infusion time, but it's really up to the individual nurse. There is no policy governing it.

rnkaytee

219 Posts

We have a goal to get antibiotics infusing within 1 hour of ordering so waiting the 2 hours would defeat that purpose - we just give Amp and then gent right after - we also stop HA while giving Amp.

Has 10 years experience.
We give Amp first because it is a faster infusion time then Gent right after. We flush in between so the meds are separated.

This is what we do. If you flush, there are no issues with incompatibility.