Four times A DAY

[questabellatreetop]

My DS has tonsillitis, he needs four doses of medicine a day. I take this to mean he needs four doses in a 24hour period, to me it's painstakingly obvious, DH says only during the day, I think that is absolutely ridiculous. Who is right?!

@Spiggle123 - it is entirely sensible to wake up during the night to take medication if the doctor has said it is necessary to do so.

But to my mind, the fact that your doctor DID tell you you needed to take them at night, backs up the fact that, generally speaking, it's not necessary to wake up/wake a child up for medicine during the night - ie. the norm is to take them spaced out evenly throughout the waking hours, and only IF it is necessary to take them during the night will the doctor say so specifically - if that makes any sense at all.

Nurse here. I would do 7am, midday, 4/5ish and 9ish. Or thereabouts. At least 4 hours in between doses.

Do you mean antibiotics or paracetamol? With antibiotics the idea is to ensure the concentration of drug in your system stays relatively constant so you spread the doses out evenly within 24 hours - in this instance every 6 hours.

4 doses in 24 hours means every 4-6 hours. It's perfectly reasonable to take them 4 hourly during waking hours. Disturbing someone's sleep TWICE isn't going to help them

If it was 3 times per day, it would be every 6-8 hours

With antibiotics the idea is to ensure the concentration of drug in your system stays relatively constant so you spread the doses out evenly within 24 hours - in this instance every 6 hours

Well that's what I've been advised by GPs on more than one occasion. It also helps because it was difficult to catch my children with an empty stomach or an hour before food. A 6am dose was a straightforward definitely empty stomach.
Also when my dcs were unwell enough to need ABs, they'd be sleeping in the daytime as well, so had to be woken up anyway at some point. Might just as well wake them up at the roughly correct timings.

Having said all that, I've never had a problem with either taking or administering them 6 hourly. It's only one wake up in a 12 hour period if you take one at the beginning and one at the end. I'm well practised as one of my dds has always had a recurring requirement for ABs.

Having said all that, I acknowledge that some people might have problems in following the dosage to the letter, or children that won't go back to sleep etc, or that it's not absolutely necessary to do so.
I do resent being called bonkers for doing it, when it's what I've been instructed by GPs to do, and it's actually the most sensible way to administer ABs if it can possibly be achieved.

With antibiotics the idea is to ensure the concentration of drug in your system stays relatively constant so you spread the doses out evenly within 24 hours - in this instance every 6 hours. And yet all the health professionals who have posted have said the exact opposite...

@GroovyLass I am a research scientist trained extensively in infectious diseases.

I meant that was the ideal (typo lost the l) from a pharmacological perspective. Whether or not a few hours plus or minus here and there makes a difference depends on the severity of the infection. Probably best for the OP to ask her pharmacist or GP rather than mumsnet, and probably best you don’t take as lore what a bunch of anonymous people on mumsnet are claiming about their qualifications.

I've never woken any of mine in the night for anti biotics. The only time we've been told to definitely wake them was when they needed inhalers for severe asthma and they were on 10 puffs every 4 hours day and night.

They've been blue lighted to hospital a number of times and had multiple hospital admissions so it's very important to keep on top of their inhalers when they're ill or have an asthma attack. Obviously different to anti biotics though.

one when he wakes up
one before he goes to bed
two others roughly evenly spaced during the day

I just give during waking hours, extending bedtime a little where necessary.

Even in hospital I have never been woken during the night to take medication, both oral and IV. Most hospitals think that sleep is crucial and won't wake unless absolutely necessary.

I’ve always given prescribed meds spread through waking hours. And if they’ve been awake in the night (needing calpol for example) and it’s been long enough between doses then I’ve given the prescribed meds then too. Helps to spread it out but I’ve never woken a poorly child!

It would patently be ridiculous to wake a sleeping child to give meds in the middle of the night

Totally agree. It's not something I've ever done, and I don;t know anyone who does this either. Space out evenly over waking hours. Job done.

Have never woken the kids, have followed the rules of 1) first thing 7am-ish, 2) lunch time so Midday, 3) afternoon so 4pm-ish and 4) last thing so 9pm-ish.... Mine tend to be up later when they are poorly as they tend to nap in the day.

When I took AB (2 lots, after being attacked by a cat!!) I did 9am, 1pm, 6pm and 11pm.

And yet all the health professionals who have posted have said the exact opposite

All the health professionals I've seen face to face in clinics and surgeries have advised me to administer every six hours, a medication which is ideally intended to be administered every six hours.

I can't be the only one who thought this thread was about something else?

Most medicines are maximum four doses minimum four hours apart. Antibiotics are definitely four times during waking hours (think about it, their effects are slow acting, usually taking up to two days to take full effect, unless the infection is life threatening consistent dosing us unnecessary).

Night nurse here; with my adult patients on 4 times daily antibiotics orally they’d have their last dose about 22-23.00 and then morning dose 06.00. IV antibiotics are 6, 12, 18, 24.

My kids have rarely had antibiotics but I would wake them in the night so they can have as close to 6 hourly as possible. I go in with a syringe so they don’t need to be wide awake to swallow 5-10 mls of suspension. If they woke in the night with pain, needing drink, loo or for comfort and it was close to the time then I’d give it then while they’re awake. I wouldn’t like them to have it 4 hourly in the day then go 12 hours without.

I wake mine (and I'm a health professional) . They work best spread out equally through 24 hours. They go straight back to sleep so it doesn't really disturb them. Also I wouldn't go by what people say just because they say they're a GP/ nurse/ whatever - I worked with a doctor who took 3 paracetamol at a time whenever she had a headache.....

I opened this thread feeling rather amused and slightly impressed, now I'm just disappointed.

Now you all tell me, I can give DS his anticonvulsants during the day not 6 hourly! 6,12,6,12 so tonight I can go to bed @ 10 and wake up @ 7.30.
Bliss!
Years ago whilst doing paediatrics we tried to give drugs regularly but admit it was difficult.

I’ve never woken mine! Mind you the only times my DCs have had antibiotics the GP said he’d prescribe three doses a day, one before breakfast, one before bed, one before lunch and then after a couple of days they should be well enough to go to school and the lunchtime dose could move to after school so that they COULD go to school.

I've only ever once had medication where it was stressed that I had to wake up in the middle of the night to have the 4th dose - I was also given the exact timings of the other doses I needed to have (think I was ending up in hospital having tests so it was worked back from the test time; it wasn't for antibiotics).

The fact that they stressed it so heavily made me think that it's not normal to wake up in the middle of the night to take a 4th dose but stretching them out as far as possible during waking hours was your best bet.

Best antibiotics I ever had were ones that I only had to have twice a day - made life so much easier. Ironically I was really quite ill at the time and they were very strong so was expecting to be on something 4x a day.

For all those HCP/Dispensing professionals out there - just wondering if there is anything that you can take with antibiotics that can make them more or less effective? For example, in the same way for instance that having grapefruit with some medicines can increase their potency/uptake (not sure of the technicalities of it!).

What would you need to wake them? I've given mine antibiotics from syringe whilst sleeping loads of times!!

4 doses in a 24 hour period so at 4-6 hour intervals