Please check your internet connection and try again.
## Cefriaxone
### Overview
Ceftriaxone is a third-generation cephalosporin antibiotic with broad-spectrum activity against many Gram-positive and Gram-negative bacteria. It is administered intravenously or intramuscularly.
### Primary Indications
* Lower respiratory tract infections (e.g., pneumonia)
* Skin and skin structure infections
* Urinary tract infections, complicated
* Pelvic inflammatory disease
* Bacterial meningitis (including *Neisseria meningitidis*)
* Surgical prophylaxis
* Uncomplicated gonorrhea
### Adult Dosing
* **General Infections:** 1-2 grams IV/IM every 12-24 hours.
* **Meningitis:** 2 grams IV every 12 hours. Some guidelines suggest up to 4 grams daily.
* **Surgical Prophylaxis:** 1-2 grams IV 30-60 minutes before incision.
* **Uncomplicated Gonorrhea:** 250 mg IM as a single dose.
### Pediatric Dosing
* **Neonates (< 28 days):** Doses vary based on weight and indication. Typically 25-50 mg/kg/day IV/IM divided every 24 hours. Avoid concurrent IV calcium administration in neonates.
* **Infants and Children (> 28 days):** 50-100 mg/kg/day IV/IM divided every 12-24 hours.
* **Meningitis:** 100 mg/kg/day IV divided every 12 hours. Maximum 4 grams daily.
Dosing for specific indications and populations may vary based on local protocols and clinical guidelines.
### Dose Adjustments
No dose adjustment is necessary for renal or hepatic impairment. However, monitor for efficacy and potential toxicity in severe impairment.
### Contraindications
* Hypersensitivity to ceftriaxone, other cephalosporins, or penicillins.
* Concurrent administration of IV calcium-containing solutions in neonates.
### Adverse Effects
Common: Rash, diarrhea, nausea, vomiting, phlebitis at injection site.
Serious: *Clostridioides difficile*-associated diarrhea, eosinophilia, leukopenia, thrombocytopenia, biliary sludging (especially in neonates), hemolytic anemia, anaphylaxis.
### Key Drug Interactions
* **Aminoglycosides:** Potential for increased nephrotoxicity, though conflicting data exists.
* **Warfarin:** May alter INR; monitor closely.
* **Probenecid:** May increase ceftriaxone levels.
### Monitoring
* Signs and symptoms of infection.
* Renal and hepatic function (baseline and periodically if clinically indicated).
* Complete blood count (periodically, especially for prolonged therapy).
* Signs of hypersensitivity reactions.
* Biliary system for signs of sludging (especially in neonates and prolonged therapy).
### Clinical Pearls
* Ceftriaxone is often a first-line agent for community-acquired pneumonia, meningitis, and gonorrhea.
* Reconstitution: Reconstitute with appropriate diluent (e.g., sterile water for injection, normal saline).
* IV Administration: Administer over 30 minutes.
* IM Administration: Administer deep into the gluteal muscle. Lidocaine may be used as a diluent for IM injection to reduce pain.
* Do not mix or co-administer ceftriaxone with calcium-containing solutions through the same IV line, especially in neonates, due to risk of precipitation.
---
*Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and institutional guidelines before administering any medication.*
