Library Dissertation Showcase

An exploration of the potential drug losses during the administration of IV medication with a focus on antibiotics

  • Year of Publication:
  • 2021

Recent research highlighted concerns regarding the amount of medication lost during administration as an intravenous infusion, due to a residual volume remaining in the line when the giving set is not flushed. This is an important issue when administering antibiotics as potentially underdosing the patient can lead to adverse outcomes and contribute to antibiotic resistance. Currently, no guidance enforces flushing the line and it is unknown whether manufacturers have accounted for this loss during drug and guidance development. Therefore, this project aimed to gain information from manufacturers to establish if their original experimental procedures accounted for this loss when setting dose recommendations.
A case study approach was taken and a list of 37 commonly prescribed intravenous antibiotics was collated, with theoretical sampling used to identify 33 manufacturers of the drugs which resulted in 129 preparations for which data was requested in total. A mixture of qualitative and quantitative data was gathered in the form of a questionnaire which was sent to manufacturers via email. Data was obtained for 21 antibiotics, with a total of 35 preparations analysed. The results show that pharmaceutical manufacturers of intravenous antibiotic preparations do not account for the dose lost to the line when setting their dose recommendations. Manufacturers expected the entire dose to be administered for 97% of the antibiotics, but the instruction to flush the line was only included in the SPCs for 3%, with the majority also not including an overage. Additionally, they only had data to support a lower than recommended dose for 23%, but it was their collective viewpoint that flushing the line is the sole responsibility of the clinician.
As a result of these findings the researcher recommends the inclusion of flushing guidance is made a mandatory requirement in the SPCs for all intravenous antibiotic preparations, to provide clinicians with clear guidance to ensure that the entire dose is administered to the patient.

PLEASE NOTE: You must be a member of the University of Lincoln to be able to view this dissertation. Please log in here.