Ceftriaxone
Mechanism :
Ceftriaxone is a semisynthetic, broad-spectrum cephalosporin antibiotic for intravenous or intramuscular administration. Cephalosporins are bactericidal because of their inhibition of cell-wall synthesis.
Indication :
- Meningitis
- Typhoid
- Pneumonia
- Otitis media
- Pyelonephritis
- Pelvic infections
- Septicaemia
- Gonococcal infections
- Septicemia
Contraindications :
Ceftriaxone is contraindicated in patients with known allergy to the cephalosporin group of antibiotics.
Dosing :
50-100 mg/kg/day IV divided in 12 hourly doses for 7-14 days. Maximum dose: 4 g/day.
In meningitis use 100 mg/kg/day.
Adverse Effect :
Injection site inflammation, rash, pruritus, fever, eosinophilia, urticaria, anaphylaxis, colitis, diarrhea, nausea, and vomiting, pseudomembranous colitis.
Interaction :
Increased nephrotoxicity has been reported following concomitant administration of cephalosporins and aminoglycoside antibiotics.
Positive direct Coombs tests have been reported during treatment with the cephalosporin antibiotics.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function. Maximum 2 g daily |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in GFR<10 mL/min |
| HD | Not dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Unknown dialysability. Dose as in GFR<10 mL/min |
| CAV/VVHD | Unknown dialysability. 2 g every 12–24 hours |
| CVVHD/HDF | Likely dialysability. 2 g every 12–24 hours |
Hepatic Dose :
No dosage adjustments are recommended. Dose adjustment may be required with both hepatic dysfunction and significant renal impairment.