Incidence of adverse effects greater than 1%: Show differences in efficacy and safety of ceftriaxone in geriatrics compared to younger patients but "greater sensitivity of some older individuals cannot be ruled out." Adverse effects Īlthough generally well tolerated, the most common adverse reactions associated with ceftriaxone are changes in white blood cell counts, local reactions at site of administration, rash, and diarrhea. Elderly Īccording to the package insert, clinical studies did not It can compete with bilirubin and displace it from binding to albumin, increasing the risk of bilirubin encephalopathy. Hyperbilirubinemic neonates are contraindicated for the use of ceftriaxone. Low concentrations of ceftriaxone are excreted in breast milk that are "not expected to cause adverse effects in breastfed infants." The manufacturer recommends that caution be exercised when administering ceftriaxone to women who breastfeed. It has not been observed to cause birth defects in animal studies, but a lack of well-controlled studies done in pregnant women exists. Specific populations Pregnancy Ĭeftriaxone is pregnancy category B. Diluents containing calcium should not be used to reconstitute ceftriaxone, and it must not be administered in intravenous lines containing other calcium-containing solutions, as a ceftriaxone-calcium precipitate could form. Available forms Ĭeftriaxone is available for administration via the intramuscular or the intravenous routes. In this case the dose should be doubled (e.g. aureus and is used in clinic for infections sustained by this bacterium. Īlthough not being used as first line therapy against Staphylococcus aures, ceftriaxone retains activity against isolates of methicillin-resistant S. Some organisms, such as Citrobacter, Providencia, and Serratia, have the ability to become resistant through the development of cephalosporinases (enzymes that hydrolyze cephalosporins and render them inactive). It is generally not active against Enterobacter species, and its use should be avoided in the treatment of Enterobacter infections, even if the isolate appears susceptible, because of the emergence of resistance. However, unlike ceftazidime and cefoperazone, ceftriaxone does not have useful activity against Pseudomonas aeruginosa. Like other third-generation cephalosporins, ceftriaxone is active against Citrobacter spp., Serratia marcescens, and beta-lactamase-producing strains of Haemophilus and Neisseria. Due to increased risk of developing azithromycin resistant strains and the high efficacy of higher doses of ceftriaxone the guidance has been updated to mono-antibiotic therapy with a higher dose of ceftriaxone. In combination with doxycycline or azithromycin, ceftriaxone used to be recommended by the United States Centers for Disease Control and Prevention (CDC) for the treatment of uncomplicated gonorrhea. Ĭeftriaxone is also a choice drug for treatment of bacterial meningitis caused by pneumococci, meningococci, Haemophilus influenzae, and "susceptible enteric Gram-negative rods, but not Listeria monocytogenes." If sepsis is being considered, empiric therapy may be initiated prior to susceptibility testing. Before using ceftriaxone, it is important to determine the susceptibility of the bacteria. Due to emergent resistance, ceftriaxone should not be used for the treatment of Enterobacter infections. Medical use A vial of ceftriaxone, manufactured and sold in RussiaĬeftriaxone and other third-generation antibiotics are used to treat organisms that tend to be resistant to many other antibiotics. It is on the World Health Organization's List of Essential Medicines. Ĭeftriaxone was patented in 1978 and approved for medical use in 1982. It is a third-generation cephalosporin that works by preventing bacteria from making a cell wall. There is tentative evidence that ceftriaxone is relatively safe during pregnancy and breastfeeding. The intravenous form should not be given with intravenous calcium. It is not recommended in those who have had anaphylaxis to penicillin but may be used in those who have had milder reactions. difficile-associated diarrhea, hemolytic anemia, gall bladder disease, and seizures. Ĭommon side effects include pain at the site of injection and allergic reactions. Ceftriaxone can be given by injection into a vein or into a muscle. It is also sometimes used before surgery and following a bite wound to try to prevent infection. These include middle ear infections, endocarditis, meningitis, pneumonia, bone and joint infections, intra-abdominal infections, skin infections, urinary tract infections, gonorrhea, and pelvic inflammatory disease. Ceftriaxone, sold under the brand name Rocephin, is a third-generation cephalosporin antibiotic used for the treatment of a number of bacterial infections.
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