Ceftriaxone Sodium for Injection (DBL)
Generic Name: Ceftriaxone sodium
Product Name: Ceftriaxone Sodium for Injection (DBL)
Indication
Ceftriaxone is used to treat the following serious infections when they are caused by susceptible organisms (see Action for a full list):
– lower respiratory tract infection
– skin and skin structure infections
– urinary tract infections, uncomplicated and complicated
– uncomplicated gonorrhoea
– bacterial blood infection (sepsis)
– bone infections
– joint infections
– meningitis
Ceftriaxone can also be used in the prevention of infection during surgery such a vaginal or abdominal hysterectomy, gall bladder removal, contaminated surgical procedures (eg: bowel surgery) and coronary artery bypass graft surgery.
As with the treatment of all infections, culture and sensitivity studies should be undertaken before institution of treatment if possible.
Action
Ceftriaxone is a broad spectrum antibiotic from the cephalosporin family. It is a known as a third generation cephalosporin, and is active against a number of bacteria not killed by first or second generation cephalosporins. Ceftriaxone kills bacteria by interfering with production of proteins important for their cell walls. It is active against a number of important and well-known organisms including:
– Staphylococcus aureus (but not MRSA)
– E. coli
– Neisseria meningitidis (meningococcus)
– N. gonorrhoeae (cause of gonorrhoea)
Ceftriaxone also kills some important causative organisms of respiratory tract infections, Haemophilus influenzae, Streptococcus pneumoniae and Klebsiella pneumoniae. Some strains of Pseudomonas aeruginosa, the bug that causes dangerous hospital infections, are also killed. A number of other bacteria responsible for a wide range of infections are also susceptible to Ceftriaxone.
Dose advice
Rocephin may be administered intravenously or intramuscularly.
Adults
– recommended daily dose is 1-2g once a day or in equally divided doses twice a day
– dose is determined based on severity of infection
Uncomplicated gonorrhoea
– single IM dose of 250mg
Surgical prophylaxis
– single dose of 1g should be administered ¨ö to 2 hours before surgery
Children
– 50-75mg/kg/day as one dose or divided doses
– dose not to exceed 2g/day
– dose should be divided and given every 12 hours in meningitis
Duration of therapy
– in general, therapy should be continued for at least two days after the symptoms of the infection have disappeared
– usual duration is 4-14 days
– treatment may be much longer for certain infections, eg: bone infection
– prolonged therapy increases risk of adverse effects
– infections caused by Streptococcus pyogenes should be treated for no less than 10 days
Renal impairment
– plasma levels should be monitored in patients with impaired renal and hepatic function, and patients with severe renal impairment
– serum levels should not exceed 280mcg/ml
Administration
– all prepared solutions should be used as soon as possible and retain their efficacy for six hours at room temperature
Intramuscular injection
– dissolve 250mg or 500mg in 2ml, or 1g in 3.5ml, of lignocaine 1% solution
– administer by deep intragluteal injection
– no more than 1g should be injected on each side
– injection without lignocaine is painful
– lignocaine solution should never be injected intravenously
Intravenous injection
– dissolve 250mg or 500mg in 5ml, or 1g in 10ml, of water for injections
– administer by direct intravenous injection over 2-4 minutes
Intravenous infusion
– dissolve 2g in 400ml of any IV fluid NOT containing calcium
– administer by infusion over at least 30 minutes
Schedule
S4
Common side effects
Ceftriaxone is generally well tolerated. The following effects are experienced relatively commonly:
– diarrhoea
– nausea
– rash
– electrolyte disturbances
– pain and inflammation at injection site
Uncommon side effects
The following effects occur less often:
– vomiting
– headache
– dizziness
– oral and vaginal thrush
– severe diarrhoea (pseudomembranous colitis)
Allergic reaction is uncommon but the symptoms are important to know and should be reported to your doctor:
– hives
– itching
– swelling
– trouble breathing
– wheezing
– widespread purple rash
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For further information talk to your doctor.
Dates
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