Ceftriaxone – Dose, ROA, MOA, PK, PD, Indications & More

Dose and Dosage:

  • The typical dose of ceftriaxone depends on the condition being treated, the severity of the infection, and the patient’s age and weight.
  • For most infections, the usual adult dose ranges from 1 to 2 grams once daily or divided into two doses every 12 hours.
  • Pediatric dosing is based on weight and may range from 50 to 100 mg/kg once daily or divided into two doses every 12 hours, not to exceed 4 grams per day.
  • The duration of treatment varies depending on the type and severity of the infection.

Frequency:

  • Ceftriaxone is typically administered once daily or divided into two doses every 12 hours.

Route of Administration (ROA):

  • Ceftriaxone is administered intravenously (IV) or intramuscularly (IM) in the form of a solution or powder for reconstitution.

Mechanism of Action (MOA):

  • Ceftriaxone is a third-generation cephalosporin antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell lysis and death.

Pharmacokinetics (PK):

  • Ceftriaxone is well-absorbed after IM administration and achieves high concentrations in various tissues and body fluids.
  • It has a long half-life of approximately 5 to 9 hours in adults and may be longer in neonates.
  • Ceftriaxone is primarily eliminated by the kidneys through glomerular filtration and tubular secretion.

Pharmacodynamics (PD):

  • Ceftriaxone exhibits concentration-dependent bactericidal activity against a wide range of Gram-positive and Gram-negative bacteria, including beta-lactamase-producing strains.

Pathophysiology:

  • Ceftriaxone is indicated for the treatment of various bacterial infections, including respiratory tract infections, skin and soft tissue infections, urinary tract infections, and intra-abdominal infections.

Indications:

  • Lower Respiratory Tract Infections: Including pneumonia and bronchitis.
  • Skin and Soft Tissue Infections: Such as cellulitis and wound infections.
  • Urinary Tract Infections: Including pyelonephritis and cystitis.
  • Intra-abdominal Infections: Such as peritonitis and cholecystitis.
  • Gonorrhea: Ceftriaxone is the preferred treatment for uncomplicated gonorrhea.
  • Meningitis: Ceftriaxone is often used in the treatment of bacterial meningitis.

Contraindications:

  • Hypersensitivity: Patients with a known hypersensitivity to cephalosporin antibiotics should not receive ceftriaxone.
  • Neonates: Ceftriaxone should not be used in neonates with hyperbilirubinemia, particularly those who are premature, have glucose-6-phosphate dehydrogenase (G6PD) deficiency, or are receiving phototherapy with blue light.

Drug Interactions:

  • Ceftriaxone may interact with other medications, including probenecid, anticoagulants, and calcium-containing solutions, potentially altering their efficacy or increasing the risk of adverse effects.

Monitoring and Laboratory Tests:

  • Renal Function: Monitor renal function regularly, especially in patients with impaired renal function, to adjust the dosage accordingly.
  • Blood Tests: Periodically monitor complete blood counts and liver function tests during prolonged treatment with ceftriaxone.

Why is this medication prescribed?

Ceftriaxone is prescribed to treat a variety of bacterial infections caused by susceptible organisms. These infections may include:

  • Lower respiratory tract infections such as pneumonia and bronchitis.
  • Skin and soft tissue infections like cellulitis and wound infections.
  • Urinary tract infections including pyelonephritis and cystitis.
  • Intra-abdominal infections such as peritonitis and cholecystitis.
  • Gonorrhea, particularly when there are concerns about antibiotic resistance.
  • Bacterial meningitis.

How should this medicine be used?

Ceftriaxone is usually administered intravenously (IV) or intramuscularly (IM) by a healthcare professional in a medical setting. The dosage and duration of treatment will depend on the type and severity of the infection being treated. It’s crucial to follow your doctor’s instructions and complete the full course of treatment, even if you start feeling better.

Other uses for this medicine

Ceftriaxone may also be used off-label for certain conditions or infections not listed in the official prescribing information. However, the off-label use should only be done under the supervision of a healthcare provider.

What special precautions should I follow?

  • Inform your doctor about any allergies you have, especially to antibiotics like cephalosporins or penicillins.
  • Let your healthcare provider know about any medical conditions you have, especially kidney disease, liver disease, or gastrointestinal problems.
  • Ceftriaxone may interact with other medications, so inform your doctor about all the medications you are taking, including over-the-counter drugs, supplements, and herbal remedies.

What special dietary instructions should I follow?

There are no specific dietary restrictions while taking ceftriaxone. However, it’s essential to maintain a healthy and balanced diet to support your overall health and recovery from the infection.

What should I do if I forget a dose?

If you miss a dose of ceftriaxone, contact your healthcare provider or pharmacist for guidance. It’s essential to maintain a consistent dosing schedule to ensure the effectiveness of the treatment.

What side effects can this medication cause?

Common side effects of ceftriaxone may include:

  • Diarrhea
  • Nausea or vomiting
  • Rash or itching
  • Headache
  • Injection site reactions (for IM or IV administration)
  • Changes in taste
  • Yeast infections (in the mouth or vagina)

Less common but potentially serious side effects may include allergic reactions, severe diarrhea, or inflammation of the colon (pseudomembranous colitis). If you experience any severe or persistent side effects, contact your doctor immediately.

What should I know about storage and disposal of this medication?

Ceftriaxone should be stored according to the instructions provided by the manufacturer. Typically, it should be stored at room temperature away from light and moisture. Unused portions of the medication should be properly disposed of according to local regulations or guidelines.

In case of emergency/overdose

If you suspect an overdose or experience severe symptoms after receiving ceftriaxone, such as difficulty breathing or a severe allergic reaction, seek immediate medical attention or contact a poison control center for assistance.