1 vial 1gm

$3.80

  • Treatment of infections caused by susceptible organisms

  • Empiric treatment of bacterial meningitis

IV:
500mg, 1gm and 2gm vials of powder
Add appropriate volume of water for injection to a vial then shake well until all powder is dissolved.
Prepare the solutions as follows:

Ceftriaxone intravenous table

Inject slowly over 3-5 minutes
Store at room temperature
Compatible with:
Normal saline Glucose and sodium chloride Glucose 5%

IM:
Reconstitute with 0.5% lignocaine as follows:

Ceftriaxone intramuscular table

ADULT DOSE
IV:
1-2gm daily; for bacterial meningitis 4gm daily is required and is often administered as 2gm 12 hrly

PAEDIATRIC DOSE
IV:
50mg/kg daily
IM:
Note: for treatment of bacterial meningitis where IV access is not obtained use an IM load of 80-100 mg/kg, then 80-100 mg/kg/dose IM (max. 2000 mg/dose) every 24 hours starting 12 hrs after load.

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY
Dose as in normal renal function

Ceftriaxone is excreted via both biliary and renal excretion. The bactericidal activity of ceftriaxone results from inhibition of cell wall synthesis. Ceftriaxone has a high degree
of stability in the presence of beta lactamases, both penicillinases and cephalosporinases, of gram-negative and gram-positive bacteria.
Ceftriaxone has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections:
Aerobic Gram-Negative Microorganisms:
Acinetobacter calcoaceticus
Enterobacter aerogenes
Enterobacter cloacae
Escherichia coli
Haemophilus influenzae (including ampicillin-resistant and beta-lactamase producing strains)
Haemophilus parainfluenzae
Klebsiella oxytoca
Klebsiella pneumoniae
Moraxella catarrhalis (including beta-lactamase producing strains)
Morganella morganii
Neisseria gonorrhoeae (including penicillinase- and nonpenicillinase-producing strains)
Neisseria meningitidis
Proteus mirabilis
Proteus vulgaris
Serratia marcescens
Note:
Many strains of the above organisms that are multiply resistant to other antibiotics, e.g., penicillins, cephalosporins, and aminoglycosides, are susceptible to ceftriaxone.

Aerobic Gram-Positive Microorganisms:
Staphylococcus aureus (including penicillinase-producing strains)
Staphylococcus epidermidis
Streptococcus pneumoniae
Streptococcus pyogenes
Viridans group streptococci
Note:
Methicillin-resistant staphylococci are resistant to cephalosporins, including ceftriaxone. Most strains of Group D streptococci and enterococci, e.g., Enterococcus (Streptococcus) faecalis are resistant.

Anaerobic Microorganisms:
Bacteroides fragilis
Clostridium species
Peptostreptococcus species
Note:
Most strains of Clostridium difficile are resistant.

CONTRAINDICATIONS:

  • Hypersensivity to cephalosporins


WARNINGS
Anaphylaxis
Cephalosporins are a common cause of anaphylactic reactions and cross reactivity with penicillins may occur.

Pseudomembranous colitis
Pseudomembranous colitis has been reported with nearly all antibacterial agents, including cefotaxime, and may range in severity from mild to life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhoea subsequent to the administration of antibacterial agents.

PRECAUTIONS
General
Prescribing Ceftriaxone in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
Positive direct Coombs' tests have been reported during treatment with the cephalosporin antibiotics. It should be recognised that a positive Coombs' test may be due to the drug.

Laboratory Tests:
No tests additional to usual ICU tests are required

Drug/Laboratory Test Interactions:
None of note

Body as a Whole:
serum sickness, diaphoresis and flushing
Haematological System:
Agranulocytosis, leukocytosis, leukopaenia, lymphocytosis, thrombocytopaenia, monocytosis, eosinophilia
Urogenital System:
Elevated creatinine
Digestive System:
Diarrhoea, abdominal pain, nausea or vomiting, increased ALP and bilirubin
Nervous System:
Headache, dizziness
Skin:
Rash

Cephalosporin-Class Adverse Reactions
In addition to the adverse reactions listed above that have been observed in patients treated with ceftraixone, the following adverse reactions and altered laboratory tests have been reported for cephalosporin-class antibiotics: fever, abdominal pain, superinfection, renal dysfunction, toxic nephropathy, haemorrhage, false positive test for urinary glucose, elevated bilirubin, elevated LDH, and pancytopaenia.
Several cephalosporins have been implicated in triggering seizures, paticularly in patients with renal impairment when the dosage was not reduced. If seizures associated with drug therapy occur, the drug should be discontinued. Anticonvulsant therapy can be given if clinically indicated

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