Ceftriaxone

Ceftriaxone is an antibiotic belonging to the cephalosporin group, which is used to treat bacterial infections in your body. It is effective in infections of the brain (e.g., meningitis), lungs (e.g., pneumonia), ear, urinary tract, skin & soft tissues, bones & joints, blood and heart. Ceftriaxone is also used to prevent infections during surgery. It fights the infection by killing the bacteria. This helps to improve your symptoms and cure the underlying infection. It is given as a drip (intravenous infusion) or as an injection directly into a vein or a muscle under the supervision of a healthcare professional. Your doctor will decide the correct dose for you. This medicine will be given to you regularly at evenly spaced intervals as per the schedule prescribed by your doctor. Do not skip any doses and finish the full course of treatment even if you feel better. Stopping the medicine too early may lead to the returning or worsening of infection. The most common side effects of this medicine include diarrhea, rash, and changes in liver function tests and blood cell counts. Some people may develop temporary redness or pain at the site of injection. These side effects are usually mild but let your doctor know if they bother you or do not go away. Before taking it, you should let your doctor know if you are allergic to any antibiotics or have any kidney or liver problems. You should also let your healthcare team know all other medicines you are taking as they may affect, or be affected by this medicine. Pregnant and breastfeeding women should consult their doctor before using it.

Ceftriaxone is an antibiotic. It kills the bacteria by preventing them from forming the bacterial protective covering (cell wall) which is needed for them to survive.

• Lower Respiratory Tract Infections
• Acute Bacterial Otitis Media
• Skin and Skin Structure Infections
• Urinary Tract Infections
• Gonorrhea
• Bacterial Septicemia
• Bone and Joint Infections
• Meningitis
• Prevention of Postoperative Infections

Ceftriaxone is a 3rd generation broad-spectrum parenteral cephalosporin antibiotic. It has potent bactericidal activity against a wide range of Gram-positive and Gram-negative organisms. Like other cephalosporins and penicillins, Ceftriaxone kills bacteria by interfering with the synthesis of the bacterial cell wall. Ceftriaxone has a high degree of stability in the presence of beta lactamases. A remarkable feature of Ceftriaxone is its relatively long plasma elimination half-life of about 6 to 9 hours, which makes single or once-daily dosage of the drug appropriate for most patients. Ceftriaxone is not metabolized in the body. About 40-65% of a dose of Ceftriaxone is excreted unchanged in the urine; the remainder is excreted in the bile and ultimately found in the feces as unchanged drug and microbiologically inactive compound. The drug is highly protein bound (95%).

Ceftriaxone binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

Adult Dose:

Surgical Prophylaxis: 1 g IV 0.5-2 hours before procedure.

Pediatric Dose (1 month or older):

Renal Dose: CrCl <10 ml/min: Max 2 g/day.

Your doctor or nurse will give you this medicine. Kindly do not self administer.

For IM Injection: 250 mg or 500 mg Ceftriaxone in 2 ml Lidocaine HCl 1% injection or 1 g in 3.5 ml Lidocaine HCl 1% injection.

For IV Injection: 250 mg or 500 mg in 5 ml Water for injection or 1 g in 10 ml or 2 g in 20 ml Water for injection. Administer over 2-4 minutes or as infusion over 30 minutes.

If you miss a dose of Ceftriaxone, please consult your doctor.

Common Side Effects:

• Abnormal liver function tests
• Diarrhea
• Rash
• Nausea
• Vomiting
• Eosinophilia
• Thrombocytopenia
• Headache
• Dizziness

• [UNSAFE] Ceftriaxone may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
• Your doctor has prescribed Ceftriaxone to cure your infection and improve your symptoms. Do not skip any doses and finish the full course of treatment even if you feel better. Stopping it early may make the infection harder to treat.
• Discontinue Ceftriaxone and inform your doctor immediately if you get a rash, itchy skin, swelling of face and mouth, or have difficulty in breathing.
• Diarrhea may occur as a side effect but should stop when your course is complete. Inform your doctor if it does not stop or if you find blood in your stools.
• During prolonged treatment the blood picture should be checked at regular intervals.
• Shadows suggesting sludge have been detected by sonograms of the gallbladder; this condition is reversible on discontinuation or completion of therapy.

• Hypersensitivity to cephalosporin antibiotics.
• Hyperbilirubinaemic neonates.
• Do not use calcium or calcium-containing solutions or products with or within 48 hr of ceftriaxone administration.
• Must not be given to premature and newborn neonates (up to 28 days of age).

May increase nephrotoxicity of aminoglycosides. May diminish therapeutic effect of BCG, typhoid vaccine, Na picosulfate. May increase anticoagulant effect of vit K antagonists (e.g. warfarin). May increase serum level with probenecid. Administration with Ca-containing IV solution may cause precipitation of a crystalline material in the lungs and kidneys.

[SAFE] Consuming alcohol with Ceftriaxone does not cause any harmful side effects.

[SAFE IF PRESCRIBED] Ceftriaxone is safe to use during pregnancy. Most studies have shown low or no risk to the developing baby. Pregnancy Category B.

[CAUTION] Ceftriaxone should be used with caution during breastfeeding. Breastfeeding should be held until the treatment of the mother is completed and the drug is eliminated from her body. Ceftriaxone is excreted in human milk in low concentrations.

Pediatric dose (1 month or older): 50-75 mg/kg/day (max 2 g/day) single or 2 divided doses (pneumonia, bronchitis, skin, UTI, septicemia, bone & joint); Otitis media: 50 mg/kg (max 1 g) IM single dose; Meningitis: 100 mg/kg/day (max 4 g/day) single or 2 divided doses.

Limited information is available on dose adjustment for elderly patients.

[SAFE IF PRESCRIBED] Ceftriaxone is safe to use in patients with kidney disease. No dose adjustment of Ceftriaxone is recommended. However, inform your doctor if you have any underlying kidney disease. CrCl <10 ml/min: Max 2 g/day.

[CAUTION] Ceftriaxone should be used with caution in patients with severe liver disease. Dose adjustment of Ceftriaxone may be needed. Please consult your doctor. Dose adjustment is not recommended in patients with mild to moderate liver disease.

There is no specific antidote. Treatment of overdosage should be symptomatic.

Store in a cool, dry place (below 30°C), away from light & moisture. Keep out of the reach of children.

Ceftriaxone