Banding of Antibiotic Doses for Neonates A Bevan, A Hutchinson, P Hayes. Southampton University Hospitals NHS Trust.

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. WEIGHTCEFOTAXIME DOSE 2 – 2.5kg 150mg BD >2.5 – 3kg 200mg BD >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.