Good Hope Hospital NHS Trust

Antibiotic	Dosage	Reconstitution fluid	Volume of reconstituted fluid	Further dilutions, for intravenous infusion	Duration of administration over	Rate
Amoxycillin Sodium	1g	Water for injection	20mls	Not required	3-4 mins * give without delay	-
Benzylpenicillin Sodium †	3g	Sodium Chloride 0.9% or Water for injection	20ml	Add to 80mls Sodium Chloride 0.9% (total 100mls dilution)	3g over 30 mins	200mls/hr
Benzylpenicillin Sodium †	1.5g	Sodium Chloride 0.9% or Water for injection	10mls	Not required	5 mins	-
Cefuroxime Sodium	750mg	Water for injection	6 *at least 2mls of water for each 250mg	Not required	3 mins	-
Clindamycin Phosphate (Dalacin®Phosphate)	900mg (1+½ vials)	Sodium Chloride 0.9%	→	Add to 100mls Sodium Chloride 0.9%	30 mins	200mls/hr *rate not to exceed 30mg/min
Co-Amoxiclav 250/125 (Augmentin)	1.2g	Water for injection	20mls	Not required	3-4 mins *use within 20 mins of reconstitution	-
Erythromycin	1g	Water for injection	20mls	Add to 250mls Sodium Chloride 0.9% (total 270mls dilution)	60 mins * use within 8 hours of reconstitution	270mls/hr
Gentamicin Sulphate	120mg (1+½ vials)	Sodium Chloride 0.9%	→	Add to 100mls Sodium Chloride 0.9%	30 mins	200mls/hr
Vancomycin	1g	Water for injection	20mls	Add to 250mls Sodium Chloride 0.9% (total 270mls dilution)	2 hours (120 mins)	135 mls/hr *rate not to exceed 10mg/min

Condition	Specific Antibiotic (s)	Reconstitution & duration of administration	Rate
Chorioamnionitis	Cefuroxime Sodium 750mg and Metronidazole 500mg/100mls (bag) GIVE WITHIN ONE (1) HOUR OF MIXING	*reconstitute Cefuroxime Sodium as indicated above Give over 20 mins, every 8 hours until delivery	330mls/hr
Group B Streptococci	One (1) dose of Benzyl penicillin G 3g then further doses of 1.5g Penicillin allergies use: Clindamicin 900mg	*reconstitution and duration as indicated above. Benzylpenicillin given every 4 hours until delivery Clindamycin given every 8 hours until delivery	As above
Valvular heart disease (heart murmur)	Amoxycillin 1g and Gentamicin 120mg GIVE EACH ANTIBIOTIC SEPARATELY Penicillin allergies use: Vancomycin 1g and Gentamicin 120mg GIVE EACH ANTIBIOTIC SEPARATELY	*reconstitution and duration as indicated above Amoxycillin and Gentamicin given every 8 hours until delivery Vancomycin given every 12 hours until delivery Gentamicin given every 8 hours until delivery	As above
Maternal Pyrexia	Cefuroxime Sodium 750mg and Metronidazole 500mg/100mls (bag) GIVE WITHIN ONE (1) HOUR OF MIXING	*reconstitute Cefuroxime Sodium as indicated above Give over 20 mins, every 8 hours until delivery	330mls/hr

please check patients allergy status before drug prescription and administration
patients with restricted fluid intake will require revised dilution and infusion rate – consult Registrar

†Benzylpenicillin 3g can be obtained from two 1.2g vials plus one 600mg vial
1.5g can be obtained from a 1.2g vial plus half of a 600mg vial. To obtain desired 1.5g reconstitute 1.2g & 600mg vials
with 12mls of Sodium Chloride 0.9% or Water for injection, discarding 2mls leaving 10mls

Author

M Dobson, D Pillay

Guideline No: 45-Intravenous antibiotics in pregnancy

Version: 1.1.1

Dated: January 2007