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ceftriaxone

ceftriaxone

see also:

introduction

  • a 3rd generation broad spectrum parenteral cephalosporin
  • similar antibiotic coverage to cefotaxime but can be given in once daily or twice daily dosing.
  • im doses are usually given with local anaesthetic added
  • category B1 for pregnancy
  • low concentrations of ceftriaxone are excreted in human milk
  • dosage adjustments should not be necessary in patients with hepatic dysfunction
  • half-life of ceftriaxone may be prolonged in some patients with renal failure, adjustment of dosage may be required.

contraindications

  • should not be used if PH severe type 1 HS reaction to penicillin or any HS to cephalosporin
  • im solution should not be used in those hypersensitive to local anaethetics such as lignocaine
  • must not be administered with calcium containing solutions in newborn infants because of the risk of precipitation of ceftriaxone calcium salt.
  • ceftriaxone and IV calcium containing solutions must not be administered within 48 hours of each other in newborn infants

adverse effects

  • hypersensitivity reactions - as with other cephalosporins there is some cross-reactivity with penicillin allergy
  • biliary sludging - may rarely cause pancreatitis
  • may prolong INR in patients with low vitamin K stores
  • false positive tests for galactosaemia and Coomb's test
  • eosinophilia (6%), thrombocytosis (5%), leucopenia (2%), haemolytic anaemia (<1%)
  • elevated LFT's (3%)
  • other rare adverse effects see full PI.

dose

  • uncomplicated gonococcal disease: 150mg iv or im single dose only
  • pre-op high risk abdominal surgery: 50mg/kg up to max 1g iv single dose 30-120min pre-op
  • urinary tract infections (UTIs) / cystitis, pneumonia, etc: 25mg/kg up to max 1g iv daily
  • severe infections: 50-75mg/kg up to max 2g iv daily
  • meningitis: 50mg/kg to max 2g iv 12hrly

administration

Should not be added to solutions containing calcium such as Hartmann's solution. Must not be given within 48hrs of calcium infusion in neonates.

intravenous slow injection for up to 1g doses

  • dissolve 0.5g in 5ml or 1g in 10ml water for injections, administer iv over 2-4 minutes

intravenous infusion for 2g doses

  • 2 g dissolved in approximately 40 mL 0.9% saline or other calcium free solution
  • administer over at least 30 minutes

intramuscular injection

  • 0.5 g dissolved in 2 mL, or 1 g in 3.5 mL, of lignocaine 1% solution, administered by deep intragluteal injection.
  • no more than 1 g be injected on either side.
NEVER give the lignocaine solution iv!!
ceftriaxone.txt · Last modified: 2012/01/09 13:56 (external edit)