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Archive March 2020 XXI, No. 3

Ideas That Work: Infection Prevention

Push for Savings With Powdered Antibiotics

Lakeside Surgery Center
MIXING IT UP A nurse at Lakeside Surgery Center mixes a powdered antibiotic, which will be manually administered through the patient's IV tubing for three to five minutes.

The one- and two-gram IV piggyback infusion bags of the antibiotic cefazolin we were using exclusively in 2018 were almost always on backorder and delivery took several months. They were also expensive. A case of one-gram bags of cefazolin cost about $141. (We were charged $260 a case when it was on backorder.) A case of the two-gram bags cost $415.

I thought there had to be a better option and discovered that administering cefazolin via a three- to five-minute IV push is safe and effective. It's also much less expensive. A case of one-gram vials costs $17.50 — an eighth of the price of a case of the infusion bags on the rare occasions they were in stock. We reconstitute the powder with sterile water. The mix remains stable for six hours at room temperature and for seven days in a refrigerator. Once drawn into a syringe, it's best to be given within an hour. As a safety check, we label syringes with the medication, dosage level and the time and date the mix was drawn into them. We've done away with IV bags of cefazolin and now stock only powder vials. Our expected annual savings from the switch: more than $18,000.

Sarah Hatfield, BSN, RN
Lakeside Surgery Center
Omaha, Neb.

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