Ceftriaxone

Ceftriaxone - Use | Dose | Side Effects

Ceftriaxone is the drug from the group of third generation of cephalosporin antibiotics. It has a broad spectrum of activity and exerts a bactericidal effect against gram positive and gram negative bacteria. It is resistant to the action of an enzyme called beta lactamase, which is formed by the bacteria in order to fight against antibiotics. Ceftriaxone disrupts bacterial cell wall synthesis and thus leading to bacterial cell death.

Ceftriaxone exists only in the forms for parenteral administration (injections and infusions).

What precautions should be taken while using Ceftriaxone?

Ceftriaxone is contraindicated in the following conditions:

  • In patients who are allergic to Ceftriaxone, other cephalosporin antibiotics or penicillin
  • In premature babies
  • In babies younger than one month
  • In babies who have recently received an injection containing calcium

Ceftriaxone should be administered cautiously in the following situations:

  • In patients who have a liver disorders
  • In patients who have a blood disorders
  • In patients with kidney disorders
  • In patients who have recently received calcium injections
  • In patients who are on low sodium diet
  • In patients who have recently had an antibiotic-induced diarrhea

Ceftriaxone, pregnancy and breastfeeding

According to the FDA, Ceftriaxone is classified in group B. There are no well-controlled studies demonstrating its safety during pregnancy. If your physician estimates that the benefit to the mother outweighs the risk to the fetus, than Ceftriaxone may be administered during pregnancy.

It can be used during breastfeeding, but you should bear in mind that small amounts of the drug can reach the breast milk.

Dosage

Ceftriaxone can be administered only in a healthcare setting and by trained medical personnel.

Dosage mostly depends on the severity of infection and patient's body weight.

The recommended dose for patients who weigh more than 100 pounds (50 kg) is given in the table below:

Type of infection Dose
Acute exacerbation of chronic obstructive pulmonary disease 1000-2000 mg once daily (IM or IV)
Hospital-acquired pneumonia 2000 mg once daily (IM or IV)
Community-acquired pneumonia 1000-2000 mg once daily (IM or IV)
Complicated skin infections 2000 mg once daily (IM or IV)
Complicated and uncomplicated urinary tract infections 1000-2000 mg once daily (IM or IV)
Bacterial infection caused by low number of neutrocytes 2000-4000 mg once daily (IM or IV)
Meningitis 2000-4000 mg once daily (IM or IV)
Endocarditis 2000-4000 mg once daily (IM or IV)

In children who weigh less than 110 pounds (50 kg), the dose should be calculated according to children's body weight.

The dose in children is in the range of 22.5 - 45 mg / lb. or 50-100 mg / kg, respectively.

So if your child weighs 50 pounds, then the dose is in the range 1125-2225 mg per day depending on the severity of the infection.

Ceftriaxone is administered as an intramuscular injection or intravenous infusion. It should not be mixed with Ringer's or Hartmann's solution because these solutions contain calcium. Ceftriaxone builds a complex chemical compound with calcium (Ceftriaxone-calcium) that can precipitate in the lungs and cause a serious adverse effects.

Interactions

Application of the Ceftriaxone is contraindicated in combination with the following drugs:

  • Oral anticoagulants. Ceftriaxone increases antagonistic effect on vitamin K, which increases the risk of bleeding.

Adverse effects

Ceftriaxone may cause the following adverse effects:

  • Eosinophilia
  • Leukopenia
  • Thrombocytopenia
  • Granulocytopenia
  • Anemia
  • Genital fungal infections
  • Coagulopathy
  • Pseudomembranous colitis
  • Urticaria
  • Edema
  • Anaphylaxis
  • The presence of blood in urine
  • The presence of sugar in the urine
  • Glossitis
  • Stomatitis
  • Adverse reactions at the site of application