So I work at the outpatient pharmacy at my city’s Children’s Hospital, and we’re used to odd dosing on certain meds. Antibiotics, however, are not usually in that category.... until this week when a resident sent us an Rx for Keflex liquid at a dose of 200ml per dose, 4 times/day. Of course we all gawked at it and immediately called this medical resident who wrote it. Instead of the “my bad” response we were expecting, she defended her dosing. It went a little something like this:

Me (RPh): we got this Rx and it’s way too high of a dose even for an adult.

Med Res.: well that’s what I got from LexiComp

Me: ???????????????????????? But what mg/kg dose were you aiming for?

Med Res: idk I just looked at LexiComp! I wanted it for prophylaxis, so use whatever you use for that.

Me (partly to myself): yes but WhAt dOsE DiD You ActUalLy WaNt there is a range of 30-100mg/kg/day you have to pick something, you are the doctor prescribing this, you know what they’re being treated for.

So needless to say, she didn’t actually know what dose she wanted and ended up having one of her colleagues send us down a new Rx. This one blew my mind because she didn’t seem to care at all about the child she was treating, just that she wanted to defend that she was right. Usually I totally understand when mistakes happen, but when people can’t put their pride aside to improve patient care, I am a lot less understanding.

(But seriously, imagine telling parents “give one whole 200ml bottle of Keflex to your infant”)