The use of ampicillin and ampiclox solutions for parenteral injection in the pediatric ward

In our hospital, injectable ampicillin and ampiclox are available in one form only; vials containing 500 mg of the drug. When used for intravenous or intramuscular injection, these drugs are dissolved in 4-5' ml of distilled water or isotonic normal saline. If the recommended dose is 125-250 mg at a time, part of the dissolved drug is injected. The remaining part is not discarded, it is rather reused 6-8 hourly thereafter. This faulty attitude is contradictory to the scientific facts related to the stability of ampicillin and ampiclox solutions, that recommend the use of them within one hour of their dissolution and discarding the unused part. About three quarters of ampicillin users (72.27 %), and more than half of ampiclox users (54.87 %) were receiving the drugs in the faulty way, i.e. many hours after their dissolution. The study recommended that one of the following to be undertaken to bypass this therapeutic disorder: (1) provision of vials containing 125250 mg of the drugs, or (2) discarding the remaining parts of the dissolved drugs, or (3) dissolving these two drugs in 20 ml of the diluent as they have a better stability at low concentration (8 hours), and if kept at the refrigerator (24-48 hours), or (4) establishment of a full-time working pharmacy units to supply the wards with the amounts of ampicillin or ampiclox that are required for the patients, time by time, besides its provision of other sorts of drugs instead of lending them from the pharmacy of the casualty department at times of need. The study recommends as well infusing ampicillin solution slowly (10-15 minutes), as more rapid infusion may cause convulsive seizures.