Banding of Antibiotic Doses for Neonates

1
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.
• The procedure for prescribing also included a
  guide on the timing of doses.
• 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.

  WEIGHT
CEFOTAXIME DOSE   2
2.5kg 150mg BD   
gt2.5 3kg 200mg BD
    gt3 3.5kg
300mg BD     gt3.5 4kg
350mg BD     gt4kg
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.