Appendix 1: Preparation of Parental Antibiotics

Preparation and Administration of Ceftriaxone lg deep intramuscular Injection

To reduce the pain experienced by patients receiving intramuscular ceftriaxone the drug is administered with 1% lidocaine (lignocaine)
1. Take I gram vial of ceftriaxone powder
2. Draw up 3.5mls lidocaine 1% into a syringe
3. Reconstitute the 1 gm vial of ceftriaxone with 3.5mls of lidocaine 1%.
4. Draw up the reconstituted ceftriaxone solution from the vial into one syringe. This makes a total of 4.1 mls.
5. Administer the 4.1mls solution of ceftriaxone l gram by deep intramuscular injection. Well developed muscles e.g. ventrogluteal, vastus lateralis and dorsogluteal can take up to 5 mls volume. NOTE: Lidocaine must be prescribed on NaSH.

Preparation and Administration of Spectinomycin 2g Intramuscular Injection

Spectinomycin 2g reconstituted with 3.2ml bacteriostatic water (supplied) and to shake vigorously. Once dissolved to be drawn up as 5ml.
The solution should be administered by a single deep intramuscular injection.

Preparation and Administration of Gentamicin 240mg Intramuscular Injection

Due to volume this dose requires to be split
Open up 3 vials of 80mgs/2mls gentamicin, totalling 6mls (=240mg).
Take two 5ml syringes and draw 3mls solution into each syringe.
Give by deep intramuscular injection, 3 mls per side.