Comparative Evaluation of IV Push Versus IV Infusion Administration of Levetiracetam Tavin Cook, Ashley Crisler, T.J. Henderson, Aayush Patel
Piedmont Columbus Regional Midtown, Columbus GA
Background: Levetiracetam is commonly administered as an IV infusion; however, IV push (IVP) administration has the potential to improve medication turnaround times, reduce nursing workload, and lower medication preparation costs without compromising safety. In January 2026, Piedmont Columbus Regional implemented IVP levetiracetam hospital wide. The objective of this study is to compare the timeliness of administration and cost difference associated with IVP levetiracetam versus IV infusion levetiracetam.
Methods: This study was a single-center, Institutional Review Board (IRB)–approved, retrospective chart review. The overall study timeframe spanned from October 13, 2025, to March 13, 2026. The pre-implementation period was October 13, 2025, to January 12, 2026, and the post-implementation period was January 14, 2026, to March 13, 2026. The study included adult patients aged 18 years or older who received intravenous levetiracetam at doses of less than 2 grams. An EHR Slicer/Dicer data collection tool was used to collect points of time of order entry, order verification, and administration of medication. Cost analyses were conducted by integrating direct drug cost. The primary objective is to assess the difference in time from order verification to administration of once dose levetiracetam pre and post implementation. Secondary objectives include direct drug cost, time-critical medication compliance, and adverse drug reactions. Statistical analysis for the primary outcome used Mann-Whitney-U, secondary outcome descriptive analysis and chi-square testing.
Results:IV push levetiracetam demonstrated a numerically faster time to administration compared to IV infusion (19.7 vs 23.9 minutes), though this difference was not statistically significant (p=0.41). Time-critical medication compliance was significantly higher with IV push (85.7% vs 81.8%, p<0.001), and no adverse drug reactions were reported in either group. Additionally, IV push was associated with substantially lower direct drug costs, translating to significant projected annual savings.
Conclusions: IV push levetiracetam is a cost-effective alternative to IV infusion that improves time-critical medication compliance while maintaining a comparable safety profile. Although a faster administration trend was observed, it did not reach statistical significance. Overall, IV push represents a practical and efficient strategy for levetiracetam administration within institutional practice.
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