Ceftriaxone

Third generation broad-spectrum cephalosporin antibacterial

Dosage forms
Powder for injection: 1g

Uses
– Acute bacterial meningitis
– Septicaemia
– Pneumonia
– Abnormal vaginal/ urethral discharge syndrome
– Pelvic inflammatory disease
– Severe gonococcal infection
– Gonococcal eye infection in new born infant
– Dysentery

Dose and duration
IV injection should be given slowly over 2-5minutes.
Give IV infusion over 30-60minutes in neonates

– Meningitis (first line treatment)
•adult: 2g IV or deep IM injection daily in 1 or 2 divided doses for 14days
•child: 50-100mg/kg daily in 1 or 2 divided doses for 14days
•neonate: 20-50mg/kg daily in 1 or 2 divided doses (maximum 50mg/kg) for 14days

– Septicaemia
•adult: 2g IV or deep IM injection daily in 1 or 2 divided doses for 10days
•child: 50-100mg/kg daily in 1 or 2 divided doses for 10days
•neonate: 20-50mg/kg daily in 1 or 2 divided doses (max 50mg/kg) for 10days

– Moderate to severe pneumonia (second line to ampicillin and gentamicin)
•adult: 1-2g IV or deep IM injection daily in 1 or 2 divided doses for 7days
•child: 50mg/kg daily in 1 or 2 divided doses for 7days
•neonate: 20-50mg/kg in 1 or 2 divided doses (max 50mg/kg) for 7days

– Abnormal vaginal/urethral discharge syndrome (in combination with metronidazole and doxycycline)
•adult: 1g single dose by deep IM injection

– Pelvic inflammatory disease; persistent urethral/vaginal discharge
•adult: 1g once daily by deep IM injection for 3days

– Severe gonococcal infection
•adult: 1g by deep IM injection once daily for 7days

– Gonococcal eye infection in new born infant (in combination with azithromycin)
25mg/kg single dose by deep injection (max 125mg)

– Dysentery (second line for severly ill children)
50-80mg/kg IV once daily for 3days

Contra-indications
– Allergy to cephalosporin
– Neonates with jaundice, low albumin levels, or acidosis

Side-effects
– Stomach upset
– Headache
– Allergic reaction
– Blood disorders

Interactions
– Calcium or calcium-containing fluids (risk of calcium-ceftriaxone deposits in urine and lungs)
– Warfarin (increased anticoagulant effect)

Pregnancy
– Can be used

Breast-feeding
– Can be used

Caution
– Rapid injection can cause devere nausea and dizziness
– Give doses of >50mg/kg in children and >1g in adults by IV infusion
– IM doses of >1g should be divided over two injection sites
– When used with calcium or calcium-containing fluids (e.g. Ringer’s lactate), there is risk of calcium-ceftriaxone deposits in urine and lungs. Higher risk in neonates dehydrated or immobilised patients.
– Reduce dose in patients with severe kidney and liver disease
– Ceftriaxone second line to ampicilin and gentamicin in severe pneumonia
– Avoid using ceftriaxone for indications not indicated or when first line treatments are available to avoid development of resistance
– Give with caution in patients with penicillin sensitivity, may have cross-sensitivity

Source: Uganda’s Practical Guidelines for Dispensing at Higher Level Health Centres

How to whitelist website on AdBlocker?

How to whitelist website on AdBlocker?

  1. 1 Click on the AdBlock Plus icon on the top right corner of your browser
  2. 2 Click on "Enabled on this site" from the AdBlock Plus option
  3. 3 Refresh the page and start browsing the site