Ceftriaxone

C difficile risk
High
Oral Bioavailability
N/A

Dosing

1 - 2 g IV q24h

2 g IV q12h

In combination with IV ampicillin2 g IV q12h

250 mg IM x 1 dose (in combination with azithromycin 1 g po x 1 dose)

Ceftriaxone is contraindicated if they require (or are expected to require) treatment with calcium-containing IV solutions, including TPNInfuse over 30 minutes

Age 0-4 wk50 mg/kg/dose IV Q24H

Age 0-7 daysAge 8-28 days50 mg/kg/dose IV Q24H50 mg/kg/dose IV Q24H

Age 0-7 daysAge 8-28 days50 mg/kg/dose IV Q24H75 mg/kg/dose IV Q24H

All Infants: 75 mg/kg/dose IV Q24H

IV, IM

50 mg/mL

Reconstitute 250mg vial with 4.9mL of sterile water for injection = 50 mg/mL

24H Refrigerate

General Information

  • Empiric therapy of bacterial meningitis.

  • Empiric therapy of nosocomial Gram negative infections (except Pseudomonas).

  • Empiric therapy of hospitalized community or nursing home acquired pneumonia.

  • Empiric therapy of spontaneous bacterial peritonitis.

  • Empiric treatment of pyelonephritis.

  • Gonorrhea (in combination with azithromycin).

Pregnancy:

  • Compatible.

  • Consider alternative to ceftriaxone (ie. cefotaxime) at the time of delivery (particularly in preterm delivery) to minimize exposure to newborn.

Breastfeeding:

  • Compatible.

  • Allergy/rash (immediate or delayed)

  • Cytopenias, eosinophilia, and hepatic and renal laboratory abnormalities

  • Pseudocholelithiasis - unclear clinical significance - uncommonly symptomatic, but frequently found by ultrasound gallbladder sludge

Ceftriaxone should not be diluted or administered simultaneously with any calcium-containing solution via a Y-site in any patient. However, ceftriaxone and calcium-containing solutions may be administered sequentially of one another for use in patients other than neonates if infusion lines are thoroughly flushed (with a compatible fluid) between infusions.

Fatal lung and kidney damage associated with calcium-ceftriaxone precipitates has been observed in premature and term neonates. Due to reports of precipitation reaction in neonates, do not reconstitute, admix, or coadminister with calcium-containing solutions, even via separate infusion lines/sites or at different times in any neonate.

Antimicrobial class: Parenteral Cephalosporin - 3rd Generation