Ceftriaxone-BC

Generic Name: Cefotaxime sodium
Product Name: Ceftriaxone-BC

Indication

Used for the treatment of infections caused by aerobic pathogens susceptible to Ceftriaxone.Including:Lower respiratory tract infections, Skin and skin structure infections, Urinary tract infectionsGonorrhoea (cervical, urethral & rectal), Bacterial septicaemia, Bone and Joint infections, Meningitis, Surgical prophylaxis.

Action

Microbiology:

Ceftriaxone is a semisynthetic broad spectrum cephalosporin antibiotic with bactericidal activity against Gram negative and Gram positive bacteria (including those with beta-lactamases)Ceftriaxone is usually active against the following pathogens:

Gram negative anaerobes: E.aerogenes, E.cloacae, E.coli, H.influenzae (including ampicillin resistant strains), Klebsiella sp., N.gonorrhoea (including penicillinase & non penicillinase producing strains), N.meningitidis, P.mirabilis, P.vulgaris, M.morganii, S.marcescens, P.aeruginosa (other Pseduomonas sp are usually resistant).Gram positive aerobes: S.aureus (including penicillinase producing strains), S.epidermidis (methicillin resistant Staphylococci are resistant to cephalosporins, including ceftriaxone), Streptococci sp. (most species of group D Streptococci are resistant, including S.faecalis & S.faecium)Pharmacokinetics:

Ceftriaxone is poorly absorbed from the gastrointestinal tract.

Following intramuscular administration, peak plasma drug levels are achieved within 2-3 hours.

33-67% of a dose is excreted as unchanged ceftriaxone in the urine.

The drug is also secreted in the bile, and inactive metabolites are also found in the faeces.

In healthy subjects, elimination half lives range from 5.8-8.7 hours in adults, 4.6 hours in children, 7.2-19 hours in neonates, and 4.0-6.6 hours in infants.Pharmacokinetics are only slightly altered in elderly patients and patients with hepatic dysfunction, therefore dosage adjustment is not necessary. However, in some patients with severe renal dysfunction, half-lives may be significantly prolonged and dosage adjustment is recommended.

Ceftriaxone crosses the placenta and appears in breast milk.

Dose advice

Intramuscular, Intravenous:Adults: 1-2 g, once daily, OR 1-2 g in equally divided doses, twice daily.Uncomplicated gonococcal infections: 250 mg, intramuscularly, stat.Preoperative use (surgical prophylaxis) in cardiovascular surgery, biliary tract surgery (in high risk patients), vaginal & abdominal hysterectomy:

1 g, 30-120 before surgery.Children: 50-75 mg/kg (< 2 g), once daily, OR in equally divided doses, every 12 hours.In the treatment of meningitis, ceftriaxone should be given every 12 hours.Patients with hepatic impairment: dosage adjustment is not required.Patients with renal impairment: serum drug levels should guide therapy in patients with severe renal impairment (e.g. dialysis patients) and patients with both hepatic and renal impairment.Use in pregnancy: Ceftriaxone should only be used during pregnancy if clearly needed.Use in lactation: Ceftriaxone should used in breastfeeding women with caution.