Uses of Ceftriaxone 500 mg: - Bacterial infections Pneumonia, Meningitis, Acute otitis media, Lyme disease, Typhoid fever, Otitis media, Pelvic inflammatory disease, Septicemia, Skin and Skin-Structure Infections, Gonorrhea, Respiratory tract infections, Urinary tract infections, Bone and Joint Infections, Chlamydia infection, Surgical Prophylaxis Hypersensitivity to cephalosporins; hyperbilirubinaemic neonates. Do not use calcium or calcium-containing solutions or products with or within 48 hr of ceftriaxone administration due to risk of calcium-ceftriaxone precipitate formation.

Third generation Cephalosporins

Ceftriaxone is a 3rd generation broad-spectrum parenteral cephalosporin antibiotic. It has potent bactericidal activity against a wide range of Gram-positive and Gram-negative organisms. Like other cephalosporins and penicillins, Ceftriaxone kills bacteria by interfering with the synthesis of the bacterial cell wall. Ceftriaxone has a high degree of stability in the presence of beta lactamases. A remarkable feature of Ceftriaxone is its relatively long plasma elimination half-life of about 6 to 9 hours, which makes single or once-daily dosage of the drug appropriate for most patients. Ceftriaxone is not metabolized in the body. About 40-65% of a dose of Ceftriaxone is excreted unchanged in the urine; the remainder is excreted in the bile and ultimately found in the feces as unchanged drug and microbiologically inactive compound. The drug is highly protein bound (95%).

How to use Ceftriaxone: Your doctor or nurse will give you this medicine. Kindly do not self administer. Administration: IV/IM Administration IV: Infuse intermittently over 30 minutes IM: Inject deep into large muscle mass Adult Dose: Susceptible infections IV/IM 1-2 g/day, up to 4 g/day for severe infections. Intra-abdominal Infections Complicated, mild-to-moderate, community acquired: 1-2 g/day IV in single daily dose or divided q12hr for 4-7 days, in combination with metronidazole Meningitis 2 g IV q12hr for 7-14 days Acute Uncomplicated Pyelonephritis 1-2 g IV qDay Typhoid fever 2 g IV once daily for 14 days. Surgical Prophylaxis Prophylaxis of surgical infection 1 g IV 0.5-2 hours before procedure Uncomplicated Gonococcal Infections Uncomplicated gonococcal infection of pharynx, cervix, urethra, or rectum: ceftriaxone 250 mg IM once plus azithromycin 1 g PO once (preferred) or alternatively, doxycycline 100 mg PO q12hr for 7 days Pelvic Inflammatory Disease 250 mg IM as single dose with doxycycline, with or without metonidazole for 14 days Child Dose: Children: IV, IM: 50–75 mg/kg/day, max 2 g/day q24h 50 mg/kg, max 1 g, 1–3 doses IM for AOM q24h 100 mg/kg/day for meningitis, max 4 g/day q12h Renal Dose: Renal impairment: CrCl (ml/min) <10 Max: 2 g daily.

May increase nephrotoxicity of aminoglycosides. May diminish therapeutic effect of BCG, typhoid vaccine, Na picosulfate. May increase anticoagulant effect of vit K antagonists (e.g. warfarin). May increase serum level w/ probenecid. Potentially Fatal: Admin w/ Ca-containing IV soln may cause precipitation of a crystalline material in the lungs and kidneys.

Hypersensitivity to cephalosporins; hyperbilirubinaemic neonates. Do not use calcium or calcium-containing solutions or products with or within 48 hr of ceftriaxone administration due to risk of calcium-ceftriaxone precipitate formation.

Common - Abnormal liver function tests - Diarrhea - Rash >10% Induration after IM injection (5-17%) 1-10% Eosinophilia (6%),Thrombocytosis (5%),Diarrhea (3%),Elevated hepatic transaminases (3%),Leukopenia (2%),Rash (2%),Increased blood urea nitrogen (BUN) (1%),Induration at IV site (1%),Pain (1%) <1% Agranulocytosis,Anaphylaxis,Anemia,Basophilia,Bronchospasm,Candidiasis,Chills,Diaphoresis,Dizziness,Dysgeusia,Flushing,Gallstones,Glycosuria,Headache,Hematuria,Hemolytic anemia,Increased alkaline phosphatase or bilirubin,Increased creatinine,Jaundice,Leukocytosis,Lymphocytosis,Lymphopenia,Monocytosis,Nausea,Neutropenia,Phlebitis,Prolonged or decreased prothrombin time (PT),Pruritus,Renal stones,Serum sickness,Thrombocytopenia,Urinary casts,Vaginitis,Vomiting

Its safety in human pregnancy has not been established. Therefore, it should not be used in pregnancy unless absolutely indicated. Low concentrations of Ceftriaxone are excreted in human milk. Caution should be exercised when Ceftriaxone is administered to a lactating mother.

Precaution: History of penicillin allergy; severe renal impairment; pregnancy and lactation; superinfection. Lactation: Drug enters breast milk in low concentrations; use with caution

There is no specific antidote. Treatment of overdosage should be symptomatic.

Vial store in a cool, dry place (below 30° C), away from light & moisture. Keep out of the reach of children.

Ceftriaxone binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

Pregnancy category: B Lactation: Drug enters breast milk in low concentrations; use with caution