APPENDIX 2: A PREPARING FORTIFIED TOPICAL ANTIBIOTICS AND PREPARING ORAL ACETAZOLAMIDE SOLUTION

Fortified Bacitracin

Add enough sterile water (without preservative) to 50,000 U of bacitracin dry powder to form 5 mL of solution. This provides a strength of 10,000 U/mL. Refrigerate. Expires after 7 days.

Fortified Cefazolin

Add enough sterile water (without preservative) to 500 mg of cefazolin dry powder to form 10 mL of solution. This provides a strength of 50 mg/mL. Refrigerate. Expires after 7 days.

Fortified Tobramycin (or Gentamicin)

With a syringe, inject 2 mL of tobramycin 40 mg/mL directly into a 5 mL bottle of tobramycin 0.3% ophthalmic solution (e.g., Tobrex). This gives a 7 mL solution of fortified tobramycin (approximately 15 mg/mL). Refrigerate. Expires after 14 days.

Fortified Vancomycin

Add enough sterile water (without preservative) to 500 mg of vancomycin dry powder to form 10 mL of solution. This provides

a strength of 50 mg/mL. To achieve a 25 mg/mL concentration, take 5 mL of 50 mg/mL solution and add 5 mL sterile water. Refrigerate. Expires after 4 days.

Reference:

Rhee DJ, Pyfer MF, eds. The Wills Eye Manual. Philadelphia: J. B. Lippincott, 1999, p. 520.

Dilute IV preparation in fruit juice such that one teaspoon (5 cc) contains correct unit dose (5–10 mg/kg/dose) (expensive) or prepare suspension with crushed pills and shake well. Expires after 5 days.

Add contents of one 500 mg IV vial to 500 ml fruit juice – shake well to dispurse. This gives a 5 mg/5 ml (teaspoonful). Must shake well before using.