How much antibiotic suspension is enough?

Objectives. Pilot data suggest that inadequate antibiotic volumes are often dispensed. Study goals were to determine the frequency of inadequate antib iotic volumes dispensed by local pharmacies, develop prescription-writing g uidelines to ensure that adequate antibiotic suspension volumes are dispens ed, and document the adequacy of verbal/written counseling pharmacists prov ide. Methods. Sixty-one local pharmacies filled prescriptions for penicillin pot assium (PCN; 250 mg/5 mL [5 mL orally 3 times daily for 10 days]) and Bactr im (trimethoprim-sulfamethoxazole [TMP-SMX] 5 mL orally twice daily for 10 days). The prescriptions noted only to "dispense a 10-day supply." Volumes were measured first as total amount dispensed and then into total doses dis pensed. Written/verbal instructions were documented. Results. The volume of PCN dispensed was 195 +/- 25 mL (range: 105-222 mL) for an average of 29.4 doses, where 30 doses were needed. TMP-SMX dispensed had a volume of 107 +/- 5 mL (range: 98-120 mL) resulting in an average of 16.5 doses, where 20 doses were needed. Twenty pharmacies (33%) did not di spense a measuring device. Verbal counseling by the pharmacist and written instructions were not uniformly given. Conclusions. We suggest calculating the actual volume needed plus an additi onal 10% to 30% of volume (depending on the viscosity). The prescription sh ould also request a medication-measuring/administering device. Patient coun seling and instruction should be expanded.