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NPPG 2008: Banding of antibiotic doses for neonates

Once a suitable formulation of a drug has been developed for childrenand neonates, there has to be a system in place in hospital to ensurethat the patients get the correct dose of the correct medicine at thecorrect time, said Amanda Bevan, care group pharmacist, SouthamptonUniversity Hospital, at the annual Neonatal and Paediatric PharmacistsGroup (NPPG) conference that was held in Sutton Coldfield from 14–16November 2008

by Peter Mulholland

Once a suitable formulation of a drug has been developed for children and neonates, there has to be a system in place in hospital to ensure that the patients get the correct dose of the correct medicine at the correct time, said Amanda Bevan, care group pharmacist, Southampton University Hospital, at the annual Neonatal and Paediatric Pharmacists Group (NPPG) conference that was held in Sutton Coldfield from 14–16 November 2008.

She presented work on dose banding of antibiotics for neonates. Dose banding is a common occurrence for adult patients, for example, for cytotoxic chemotherapy, but the wide weight ranges encountered in babies can be perceived as being a barrier to the introduction of this system for them, she said.

This service was developed to enable antibiotics to be administered locally to babies on the postnatal wards, Miss Bevan added. At Southampton, midwives do not administer intravenous medicines to babies on postnatal wards. The babies are transported at various times of the day and night to the neonatal unit for their treatment.

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 such that all the doses were to be given twice daily at specific times. Having set times has allowed a drug round service to be developed.

A range of dose syringes were made by the centralised intravenous additive service to enable each band to be made up of one or two syringes and, to date, there have not been any reported problems with the use of banded doses of antibiotics in this group of patients.

Citation: The Pharmaceutical Journal URI: 10043458

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