Classes
DEA Class; Rx
Common Brand Names; Rocephin (DSC)
- Cephalosporins, 3rd Generation
Description
Parenteral third-generation cephalosporin antibiotic
Used to treat infections such as gonorrhea, respiratory tract infections, and meningitis
Has longest half-life of all cephalosporins, allowing for once-daily dosing and for outpatient therapy
Indications
Indicated for the treatment of bacteremia and sepsis.
Contraindications
Documented hypersensitivity; hyperbilirubinemic neonates, particularly those who are premature; neonates <28 days if they receive calcium-containing IV products
Intravenous administration of ceftriaxone solutions containing lidocaine
Lidocaine contraindications if lidocaine solution used as solvent with ceftriaxone for intramuscular injection
Adverse Effects
- Induration after IM injection (5-17%)
- Eosinophilia (6%)
- Thrombocytosis (5%)
- Diarrhea (3%)
- Elevated hepatic transaminases (3%)
- Leukopenia (2%)
- Rash (2%)
- Increased blood urea nitrogen (BUN) (1%)
- Induration at IV site (1%)
- Pain (1%)
- Agranulocytosis
- Anaphylaxis
- Anemia
- Basophilia
- Bronchospasm
- Candidiasis
- Chills
- Diaphoresis
- Dizziness
- Dysgeusia
- Flushing
- Gallstones
- Glycosuria
- Headache
- Hematuria
- Hemolytic anemia
- Increased alkaline phosphatase or bilirubin
- Increased creatinine
- Jaundice
- Leukocytosis
- Lymphocytosis
- Lymphopenia
- Monocytosis
- Nausea
- Neutropenia
- Phlebitis
- Prolonged or decreased prothrombin time (PT)
- Pruritus
- Renal stones
- Serum sickness
- Thrombocytopenia
- Urinary casts
- Vaginitis
- Vomiting
Warnings
10-g pharmacy bulk package should not be used for direct infusion
Immune-mediated hemolytic anemia reported; if patient develops anemia while on ceftriaxone, stop antibiotic until etiology determined; severe hemolytic anemia, including fatalities, reported in both adults and children
May increase INR, especially in nutritionally deficient patients, hepatic or renal disease or prolonged treatment
Dosage must be adjusted in severe renal insufficiency (high dosages may cause CNS toxicity)
Superinfections and promotion of nonsusceptible organisms may occur with prolonged use or repeated therapy
Use with caution in patients with history of penicillin allergy
Use with caution in patients with history of GI disease, especially colitis
Use with caution in breast-feeding women; drug may displace bilirubin from albumin-binding sites, increasing risk of kernicterus
Abnormal gallbladder sonograms reported, possibly the result of ceftriaxone-calcium precipitates; discontinue if signs or symptoms of gallbladder disease occur
Ceftriaxone-calcium precipitates in urinary tract observed in patients receiving ceftriaxone; may be detected as sonographic abnormalities; patients may be asymptomatic or may develop symptoms of urolithiasis, and ureteral obstruction and post-renal acute renal failure; appears to be reversible upon discontinuation of therapy and institution of appropriate management; ensure adequate hydration; discontinue therapy in patients who develop signs and symptoms suggestive of urolithiasis, oliguria or renal failure and/or the sonographic findings
Pregnancy and Lactation
Available data from published prospective cohort studies, case series, and case reports over several decades in pregnant women have not established a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes
Data from published literature report that ceftriaxone is present in human milk; there are no data on effects of drug on breastfed child or on milk production
Maximum Dosage
7.5 g/day IV (6 g/day ceftazidime and 1.5 g/day avibactam).
7.5 g/day IV (6 g/day ceftazidime and 1.5 g/day avibactam).
187.5 mg/kg/day IV (150 mg/kg/day ceftazidime and 37.5 mg/kg/day avibactam; Max: 7.5 g/day [6 g/day ceftazidime and 1.5 g/day avibactam]).
187.5 mg/kg/day IV (150 mg/kg/day ceftazidime and 37.5 mg/kg/day avibactam; Max: 7.5 g/day [6 g/day ceftazidime and 1.5 g/day avibactam]).
6 to 11 months: 187.5 mg/kg/day IV (150 mg/kg/day ceftazidime and 37.5 mg/kg/day avibactam).
3 to 5 months: 150 mg/kg/day IV (120 mg/kg/day ceftazidime and 30 mg/kg/day avibactam).
1 to 2 months: Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Ceftriaxone
injectable solution
- 1g/50mL
- 2g/50mL
powder for injection
- 250mg
- 500mg
- 1g
- 2g
- 10g
- 100g