Known brand names include No current brand name; marketed as generic ceftriaxone for injection.
A third-generation cephalosporin antibiotic given IV or IM, usually once a day. It treats serious infections of the lungs, ears, skin, urinary tract, bones and joints, abdomen, blood, and brain lining, as well as gonorrhea, and is given before some surgeries to prevent infection.
Labeled use. From susceptible organisms; most C. difficile strains are resistant.
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Labeled use. Including S. pneumoniae, H. influenzae, and susceptible gram-negative bacteria.
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Labeled use. Skin and skin structure infections from susceptible organisms.
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A first choice for gonorrhea (single IM dose; current CDC dosing is higher than the 250 mg labeled dose), empiric bacterial meningitis (with vancomycin), community-acquired pneumonia needing hospital care, and pyelonephritis. Once-daily dosing suits outpatient IV therapy. It lacks activity against MRSA, enterococci, Pseudomonas, and atypical organisms such as Chlamydia, so add coverage when those are likely. In neonates, cefotaxime is often preferred because of bilirubin and calcium concerns. It can usually be given with a non-severe penicillin allergy.
Bactericidal beta-lactam that blocks bacterial cell wall synthesis. It stays active against some beta-lactamases from gram-negative and gram-positive bacteria. It reaches inflamed meninges, and its long half-life (about 6 to 9 hours in adults) allows once-daily dosing. It is cleared through both bile and urine.
The label does not describe a narrow therapeutic index or direct dosing by measured blood levels of the drug.
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Doses come from the FDA label. Study tool, not for clinical decisions.
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None at usual doses, since ceftriaxone is cleared by both bile and kidneys. Not removed by dialysis, so no extra dose is needed afterward. With both hepatic dysfunction and significant renal disease, do not exceed 2 grams per day. Watch for neurologic toxicity in severe renal impairment.
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No specific antidote. Stop the drug and give symptom-based supportive care. Hemodialysis and peritoneal dialysis do not lower levels. Overdose in severe renal impairment has caused encephalopathy and seizures.
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Animal studies at high doses showed no fetal harm, but there are no adequate human studies. Use only if clearly needed. Ceftriaxone crosses the placenta.
Skin infections: 50 to 75 mg/kg per day once daily or in two doses, up to 2 grams. Serious infections other than meningitis: 50 to 75 mg/kg per day divided every 12 hours, up to 2 grams. Acute otitis media: one IM dose of 50 mg/kg, up to 1 gram. Meningitis: 100 mg/kg first dose, then 100 mg/kg per day once daily or every 12 hours, up to 4 grams daily, usually for 7 to 14 days. Do not use in premature or hyperbilirubinemic neonates; infuse over 60 minutes in neonates.
No overall differences in safety or effectiveness. No dose change is needed up to 2 grams per day unless there is severe renal and hepatic impairment.
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