Transcript Background - University Hospital Southampton NHS Foundation Trust

Banding of Antibiotic Doses for Neonates
A Bevan, A Hutchinson, P Hayes.
Southampton University Hospitals NHS Trust.
Aim
To enable antibiotics to be administered locally to in-patient babies on the postnatal wards.
Background
 At Southampton, midwives do not administer intravenous medicines
to babies.
 Babies were transported, at various times of the day and night, to
the Neonatal Unit for their treatment to be administered.
Patients and Methods
 A range of dose bands for the first line antibiotic (cefotaxime) was
designed.
WEIGHT
CEFOTAXIME DOSE
 The procedure for prescribing also included a guide on the timing of
doses.
2 – 2.5kg
150mg BD
>2.5 – 3kg
200mg BD
 A range of dose syringes were made by the Centralised Intravenous
Additive Service (CIVAS) to enable each band to be made up from one
or two syringes.
 The dose bands range from 150mg up to 400mg.
 Doses are prescribed at 9am and 7pm.
 Syringes are made weekly in 150mg and 200mg strengths.
 Two nurses from the Neonatal Unit or one nurse and one midwife
conduct a ward round twice a day and administer the antibiotics to all
the relevant babies. The syringes are stored in the fridge on the
Neonatal Unit and are carried to the ward for the drug round.
>3 – 3.5kg
300mg BD
>3.5 – 4kg
350mg BD
>4kg
400mg BD
Results
 Having set times has allowed a drug round service
to be developed.
 The number of syringes required per week varies
and there have been occasional problems with
additional batches needing to be made.
 The system has removed the need for babies to be
transported from the postnatal wards to the neonatal unit for
their antibiotics and has made the giving of antibiotics on the
postnatal wards much easier.
 There have not been any reported problems with the use of
banded doses of antibiotics in this group of patients.
Conclusions
 Dose banding and the use of pre-filled syringes for the treatment of newborn babies on the postnatal wards is a viable
and efficient method for antibiotic treatment. Having antibiotics prescribed at set times has enabled the administration
to be carried out as a drug round.
 The system has worked well and is being considered for term babies admitted to the Neonatal Unit. It may be
considered for other drugs in other areas within the hospital in the future.