Catad_pgroup Antibiotics cephalosporins

Ceftriaxone - instructions for use

Registration number

Trade name of the drug: Ceftriaxone

International non-proprietary name:

Ceftriaxone

Chemical Name:]-7-[[(2-Amino-4-thiazolyl)(methoxyimino)acetyl]amino]-8-oxo-3-[[(1,2,5,6-tetrahydro-2-methyl-5,6- dioxo-1,2,4-triazin-3-yl)thio]methyl]-5-thia-1-azabicyclo oct-2-ene-2-carboxylic acid (as disodium salt).

Compound:

One vial contains 1.0 g of Ceftriaxone sodium salt.

Description:
Almost white or yellowish crystalline powder.

Pharmacotherapeutic group:

antibiotic, cephalosporin

ATX Code.

Pharmacological properties
Ceftriaxone is a third-generation cephalosporin antibiotic for parenteral use, has a bactericidal effect, inhibits cell membrane synthesis, and in vitro inhibits the growth of most Gram-positive and Gram-negative microorganisms. Ceftriaxone is resistant to beta-lactamase enzymes (both penicillinase and cephalosporinase produced by most Gram-positive and Gram-negative bacteria). In vitro and in clinical practice, ceftriaxone is generally effective against the following organisms:
Gram positive:
Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus A (Str.pyogenes), Streptococcus V (Str. agalactiae), Streptococcus viridans, Streptococcus bovis.
Note: Staphylococcus spp., resistant to methicillin, is also resistant to cephalosporins, including ceftriaxone. Most strains of enterococci (eg Streptococcus faecalis) are also resistant to ceftriaxone.
Gram negative:
Aeromonas spp., Alcaligenes spp., Branhamella catarrhalis, Citrobacter spp., Enterobacter spp. (some strains are resistant), Escherichia coli, Haemophilus ducreyi, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella spp. (including Kl. pneumoniae), Moraxella spp., Morganella morganii, Neisseria gonorrhoeae, Neisseria meningitidis, Plesiomonas shigelloides, Proteus mirabilis, Proteus vulgaris, Providencia spp., Pseudomonas aeruginosa (some strains are resistant), Salmonella spp. (including S. typhi), Serratia spp. (including S. marcescens), Shigella spp., Vibrio spp. (including V. cholerae), Yersinia spp. (including Y. enterocolitica)
Note: Many strains of these microorganisms, which stably multiply in the presence of other antibiotics, such as penicillins, first-generation cephalosporins and aminoglycosides, are sensitive to ceftriaxone. Treponema pallidum is sensitive to ceftriaxone both in vitro and in animal experiments. According to clinical data, ceftriaxone is effective in primary and secondary syphilis.
Anaerobic pathogens:
Bacteroides spp. (including some strains of B. fragilis), Clostridium spp. (including CI. difficile), Fusobacterium spp. (except F. mostiferum. F. varium), Peptococcus spp., Peptostreptococcus spp.
Note: Some strains of many Bacteroides spp. (eg, B. fragilis) that produce beta-lactamase are resistant to ceftriaxone. To determine the sensitivity of microorganisms, disks containing ceftriaxone should be used, since it has been shown that in vitro certain strains of pathogens can be resistant to classical cephalosporins.

Pharmacokinetics:
When administered parenterally, ceftriaxone penetrates well into tissues and body fluids. In healthy adults, ceftriaxone has a long half-life of about 8 hours. The area under the curve concentration - time in the blood serum with intravenous and intramuscular injection coincide. This means that the bioavailability of ceftriaxone when administered intramuscularly is 100%. When administered intravenously, ceftriaxone rapidly diffuses into the interstitial fluid, where it retains its bactericidal action against susceptible pathogens for 24 hours.
The elimination half-life in healthy adults is about 8 hours. In newborns up to 8 days old and in the elderly over 75 years of age, the mean elimination half-life is about twice as long. In adults, 50-60% of ceftriaxone is excreted unchanged in the urine, and 40-50% is also excreted unchanged in the bile. Under the influence of the intestinal flora, ceftriaxone is converted to an inactive metabolite. In newborns, approximately 70% of the administered dose is excreted by the kidneys. In case of kidney failure or liver pathology in adults, the pharmacokinetics of ceftriaxone almost does not change, the elimination half-life lengthens slightly. If kidney function is impaired, excretion with bile increases, and if liver pathology occurs, then excretion of ceftriaxone by the kidneys increases.
Ceftriaxone binds reversibly to albumin and this binding is inversely proportional to concentration: for example, at a drug concentration in the blood serum of less than 100 mg / l, the binding of ceftriaxone to proteins is 95%, and at a concentration of 300 mg / l - only 85%. Due to the lower content of albumin in the interstitial fluid, the concentration of ceftriaxone in it is higher than in the blood serum.
Penetration into the cerebrospinal fluid: In newborns and children with inflammation of the meninges, ceftriaxone penetrates into the cerebrospinal fluid, while in the case of bacterial meningitis, an average of 17% of the concentration of the drug in the blood serum diffuses into the cerebrospinal fluid, which is about 4 times more than in aseptic meningitis. 24 hours after intravenous administration of ceftriaxone at a dose of 50-100 mg/kg of body weight, the concentration in the cerebrospinal fluid exceeds 1.4 mg/l. In adult patients with meningitis, 2-25 hours after the administration of ceftriaxone at a dose of 50 mg/kg of body weight, the concentration of ceftriaxone was many times higher than the minimum inhibitory dose that is necessary to suppress the pathogens that most often cause meningitis.

Indications for use:

Infections caused by pathogens sensitive to ceftriaxone: sepsis, meningitis, infections of the abdominal cavity (peritonitis, inflammatory diseases of the gastrointestinal tract, biliary tract), infections of the bones, joints, connective tissue, skin, infections in patients with a reduced function of the immune system, kidney infections and urinary tract, respiratory tract infections, especially pneumonia, as well as infections of the ear, throat and nose, infections of the genitals, including gonorrhea. Prevention of infections in the postoperative period.

Dosage and administration:

For adults and children over 12 years of age: The average daily dose is 1-2 g of ceftriaxone once a day (after 24 hours). In severe cases or in cases of infections caused by moderately susceptible pathogens, the single daily dose may be increased to 4 g.
For newborns, infants and children under 12: With a single daily dosage, the following scheme is recommended:
For newborns (up to two weeks of age): 20-50 mg / kg of body weight per day (a dose of 50 mg / kg of body weight should not be exceeded due to the immature enzyme system of newborns).
For infants and children under 12: the daily dose is 20-75 mg/kg of body weight. In children weighing 50 kg or more, the adult dosage should be followed. A dose greater than 50 mg/kg body weight should be administered as an intravenous infusion over at least 30 minutes.
Duration of therapy: depends on the course of the disease.
Combination Therapy:
Experiments have shown that there is synergism between ceftriaxone and aminoglycosides in their effect on many Gram-negative bacteria. Although the potentiated effect of such combinations cannot be predicted in advance, in cases of severe and life-threatening infections (for example, those caused by Pseudomonas aeruginosa), their joint administration is justified.
Due to the physical incompatibility of ceftriaxone and aminoglycosides, it is necessary to prescribe them at the recommended doses separately!
Meningitis:
For bacterial meningitis in neonates and children, the initial dose is 100 mg/kg body weight once a day (maximum 4 g). As soon as it was possible to isolate the pathogenic microorganism and determine its sensitivity, the dose should be reduced accordingly. The best results were achieved with the following terms of therapy:
Gonorrhea:
For the treatment of gonorrhea caused by both penicillinase-forming and non-penicillinase-forming strains, the recommended dose is 250 mg once intramuscularly.
Prevention in the pre- and postoperative period:
Before infected or suspected infected surgical interventions, to prevent postoperative infections, depending on the risk of infection, a single administration of ceftriaxone at a dose of 1-2 g is recommended 30-90 minutes before surgery.
Insufficiency of kidney and liver function:
In patients with impaired renal function, provided that liver function is normal, there is no need to reduce the dose of ceftriaxone. Only in case of kidney failure in the preterminal stage (creatinine clearance below 10 ml / min) is it necessary that the daily dose of ceftriaxone does not exceed 2 g.
In patients with impaired liver function, provided that kidney function is preserved, there is no need to reduce the dose of ceftriaxone.
In cases of simultaneous presence of severe pathology of the liver and kidneys, the concentration of ceftriaxone in the blood serum should be regularly monitored. In patients undergoing hemodialysis, there is no need to change the dose of the drug after this procedure.
Intramuscular administration:
For intramuscular administration, 1 g of the drug must be diluted in 3.5 ml of a 1% solution of Lidocaine and injected deep into the gluteal muscle, it is recommended to inject no more than 1 g of the drug into one buttock. Lidocaine solution should never be administered intravenously!
Intravenous administration:
For intravenous injection, 1 g of the drug must be diluted in 10 ml of sterile distilled water and injected slowly intravenously over 2-4 minutes.
Intravenous infusion:
The duration of intravenous infusion is at least 30 minutes. For intravenous infusion, 2 g of powder must be diluted in approximately 40 ml of a calcium-free solution, for example: in 0.9% sodium chloride solution, in 5% glucose solution, in 10% glucose solution, 5% levulose solution.

Side effects:
Systemic side effects:
from the gastrointestinal tract (about 2% of patients): diarrhea, nausea, vomiting, stomatitis and glossitis.
Changes in the blood picture (about 2% of patients) in the form of eosinophilia, leukopenia, granulocytopenia, hemolytic anemia, thrombocytopenia.
Skin reactions (about 1% of patients) in the form of exanthema, allergic dermatitis, urticaria, edema, erythema multiforme.
Other rare side effects: headaches, dizziness, increased activity of liver enzymes, congestion in the gallbladder, oliguria, increased serum creatinine, fungal infections in the genital area, chills, anaphylaxis or anaphylactic reactions. Extremely rarely, pseudomembranous enterocolitis and a violation of blood coagulation are noted.
Local side effects:
After intravenous administration, phlebitis was noted in some cases. This phenomenon can be prevented by slow (within 2-4 minutes) administration of the drug. The described side effects usually disappear after cessation of therapy.

Contraindications:

Hypersensitivity to cephalosporins and penicillins. First trimester of pregnancy.

Drug interaction:
Do not mix in the same infusion bottle or in the same syringe with another antibiotic (chemical incompatibility).

Overdose:

Excessively high plasma concentrations of ceftriaxone cannot be reduced by hemodialysis or peritoneal dialysis. Symptomatic measures are recommended for the treatment of cases of overdose.

Special instructions:

Despite a detailed history taking, which is also the rule for other cephalosporin antibiotics, the possibility of developing anaphylactic shock cannot be ruled out, which requires immediate treatment - first adrenaline is administered intravenously, then glucocorticoids.
Sometimes an ultrasound of the gallbladder shows a shadow indicating sedimentation. This symptom disappears after the end or temporary discontinuation of ceftriaxone therapy. Even in the presence of pain, such cases do not require surgical intervention, conservative treatment is sufficient.
In vitro studies have shown that, like other cephalosporin antibiotics, ceftriaxone is able to displace bilirubin bound to serum albumin. Therefore, in newborns with hyperbilirubinemia, and especially in premature newborns, the use of ceftriaxone requires even greater caution. Since the drug passes into breast milk, breastfeeding should not be continued during treatment with ceftriaxone.
With prolonged use, periodic monitoring of the blood formula is necessary. Ceftriaxone is used only in a hospital setting.

Release form
Powder for solution for injection, 1.0 g in glass vials, each vial is packed in a cardboard box with instructions for medical use.

Storage conditions
In a place protected from light, at a temperature not exceeding 25 ° C. Keep out of the reach of children.

Best before date
2 years.
Do not use after the expiry date stated on the packaging.

Terms of dispensing from pharmacies
Released by prescription.

Manufacturer:

"Vertex Exports", India.

Comments

(visible only to specialists verified by the editors of MEDI RU)

Ceftriaxone - price, availability in pharmacies

The price at which you can buy Ceftriaxone in Moscow is indicated. You will receive the exact price in your city after switching to the online ordering service for medicines.

3rd generation cephalosporin

Active substance

Ceftriaxone (as sodium salt) (ceftriaxone)

Release form, composition and packaging

Powder for solution for intravenous and intramuscular administration crystalline, almost white or yellowish.

Glass bottles (1) - packs of cardboard.

pharmachologic effect

Semi-synthetic cephalosporin antibiotic of the third generation with a wide spectrum of action.

The bactericidal activity of ceftriaxone is due to the suppression of the synthesis of cell membranes. The drug is highly resistant to the action of beta-lactamases (penicillinase and cephalosporinase) of gram-positive and gram-negative microorganisms.

Ceftriaxone active against gram-negative aerobic microorganisms: Enterobacter aerogenes, Enterobacter cloacae, Escherichia coli, Haemophilus influenzae (including strains resistant to), Haemophilus parainfluenzae, Klebssiella spp. (including Klebssiella pneumoniae), Neisseria gonorrhoeae (including strains that form and do not form penicillinase), Neisseria meningitidis, Proteus mirabilis, Proteus vulgaris, Morganella morganii, Serratia marcescens, Citrobacter freundii, Citrobacter diversus, Providencia spp. , Salmonella spp., Shigella spp., Acinetobacter calcoaceticus.

A number of strains of the above microorganisms that are resistant to other antibiotics, such as penicillins, cephalosporins, aminoglycosides, are sensitive to ceftriaxone.

Individual strains of Pseudomonas aeruginosa are also sensitive to the drug.

A drug active against gram-positive aerobic microorganisms: Staphylococcus aureus (including strains that form penicillinase), Staphylococcus epidermidis (methicillin-resistant staphylococci are resistant to all cephalosporins, including ceftriaxone), Streptococcus pyogenes (group A beta-hemolytic streptococci), Streptococcus agalactiae (group B streptococci ), Streptococcus pneumoniae; anaerobic microorganisms: Bacteroides spp., Clostridium spp. (with the exception of Clostridium difficile).

Pharmacokinetics

Suction

When administered intramuscularly, ceftriaxone is well absorbed from the injection site and reaches high serum concentrations. The bioavailability of the drug is 100%.

With simultaneous appointment with drugs that reduce platelet aggregation (NSAIDs, salicylates, sulfinpyrazone), the risk of bleeding increases. With simultaneous appointment with marked increase in the action of the latter.

With simultaneous appointment with "loop" diuretics, the risk of developing a nephrotoxic effect increases.

Ceftriaxone and aminoglycosides are synergistic against many Gram-negative bacteria.

Incompatible with ethanol.

Pharmaceutical interaction

Ceftriaxone solutions should not be mixed or administered simultaneously with other antimicrobials. Ceftriaxone must not be mixed with solutions containing calcium.

special instructions

With long-term treatment, it is necessary to regularly monitor the picture of peripheral blood, indicators of the functional state of the liver and kidneys.

During treatment, you can not drink alcohol, since disulfiram-like effects are possible (flushing of the face, spasm in the abdomen and in the stomach, nausea, vomiting, headache, lowering blood pressure, tachycardia, shortness of breath).

Despite a detailed history taking, which is the rule for other cephalosporin antibiotics, the possibility of developing anaphylactic shock cannot be ruled out, which requires immediate therapy - epinephrine is administered intravenously first, then corticosteroids.

In vitro studies have shown that, like other cephalosporin antibiotics, ceftriaxone is able to displace bilirubin bound to serum albumin. Therefore, in newborns with hyperbilirubinemia and, especially in premature newborns, the use of ceftriaxone requires even greater caution.

Elderly and debilitated patients may require the appointment of vitamin K.

Store the prepared solution at room temperature for no more than 6 hours or in a refrigerator at a temperature of 2-8 ° C for no more than 24 hours.

Pregnancy and lactation

The use of the drug during pregnancy is possible only in cases where the intended benefit to the mother outweighs the potential risk to the fetus, tk. ceftriaxone crosses the placental barrier.

If necessary, the use of the drug during lactation should decide on the termination of breastfeeding, tk. ceftriaxone is excreted in breast milk.

For impaired renal function

With caution, the drug is prescribed for violations of kidney function.

With simultaneous severe renal and hepatic insufficiency, in patients on hemodialysis, plasma concentrations of the drug should be regularly determined.

With long-term treatment, it is necessary to regularly monitor the indicators of the functional state of the kidneys.

For impaired liver function

With simultaneous severe renal and hepatic insufficiency, in patients on hemodialysis, plasma concentrations of the drug should be regularly determined.

With long-term treatment, it is necessary to regularly monitor the indicators of the functional state of the liver.

In rare cases, ultrasound of the gallbladder shows blackouts that disappear after stopping treatment (even if this phenomenon is accompanied by pain in the right hypochondrium, it is recommended to continue prescribing an antibiotic and performing symptomatic treatment).

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

The drug should be stored out of the reach of children, dry, dark place at a temperature not exceeding 25°C. Best before date - 3 years

According to the international classification, the antibacterial drug Ceftriaxone belongs to the semi-synthetic antibiotics of the third generation of the cephalosporin series. It has a wide spectrum of action, resistance to beta-lactamase, and bactericidal effect against many gram-positive and gram-negative, both aerobic and anaerobic bacteria.

What is Ceftriaxone
Antibacterial activity of ceftriaxone
Interaction with other drugs
Side effects
How to use Ceftriaxone
Solution preparation

What is Ceftriaxone

The destruction of bacteria occurs due to a violation of the synthesis of murein, an important component of the bacterial cell wall. Also, the features of most antibiotics of the cephalosporin series include poor absorption in the intestines and an irritating effect on the gastrointestinal tract, as a result of which Ceftriaxone can only be found in the form of a powder for the preparation of injection solutions.

Another reason for the popularity of this drug is the low toxicity and relatively rare occurrence of side effects, which is typical for the vast majority of beta-lactam antibacterial drugs. Ceftriaxone is well distributed in all tissues and body fluids, penetrates the blood-brain and hematoplacental barrier, reaching a therapeutic concentration of the drug is possible, including in the cerebrospinal fluid.

A wide range of antibacterial action, low toxicity, and relatively low (compared, for example, with carbapenems) cost of the drug explain the high frequency of Ceftriaxone injections in the treatment of a wide variety of bacterial infections.

Antibacterial activity of ceftriaxone

Having a wide spectrum of action, Ceftriaxone exhibits a bactericidal effect against such pathogens:

Staphylococcus aureus is the causative agent of many diseases - from acne and boils to nosocomial pneumonia, meningitis and other deadly diseases.
Pneumococcus is a common causative agent of community-acquired pneumonia and sinusitis.
Haemophilus influenzae is the cause of pneumonia and meningitis.
E. coli - some strains can cause food poisoning.
Klebsiella is the causative agent of pneumonia, as well as urogenital infections.
Gonorrhea is the causative agent of gonorrhea.
Pseudomonas aeruginosa is a common cause of wound suppuration.
Clostridium is the causative agent of gas gangrene.

Ceftriaxone can also be effective in diseases caused by bacteroids, moraxels, and proteus.

When using Ceftriaxone injections, there is no positive dynamics in infections caused by methicillin-resistant strains of staphylococci, some strains of streptococci and enterococci.

The spectrum of antibacterial activity of III generation cephalosporins and Ceftriaxone in particular is quite wide, due to which this drug is used to treat many diseases caused by bacteria.

Interaction with other drugs

In the case of the combined use of Ceftriaxone with antibacterial drugs from a number of aminoglycosides, polymyxins, as well as with Metronidazole, an increase in efficiency is observed. Ceftriaxone injections while taking loop diuretics (Furosemide, Ethacrynic acid) can significantly increase the likelihood of toxic kidney damage.

When Ceftriaxone is used simultaneously with non-steroidal anti-inflammatory drugs, the likelihood of bleeding increases, it enhances the effect of anticoagulants.

Not compatible with ethyl alcohol. With the simultaneous administration of injections of Ceftriaxone and alcohol, a so-called disulfiram-like reaction occurs, which develops as a result of inhibition of enzymes responsible for neutralizing the toxic metabolite of ethanol, acetaldehyde. This side effect is manifested by reddening of the upper body, a feeling of heat, nausea, vomiting, difficulty breathing, palpitations, a drop in blood pressure, in some cases up to collapse.

The doctor who usually prescribes antibacterial drugs takes into account all the features of drug interaction, only a specialist can choose safe combinations, but it is better to refrain from taking alcohol during treatment with any antibiotics.

Side effects

Like any serious drug, Ceftriaxone has a lot of described side effects, although they are relatively rare in cephalosporin antibacterial drugs.

List of possible side effects:

Of the local reactions can be observed: pain or induration at the injection site, very rarely, after intravenous injections of Ceftriaxone, phlebitis develops.
Hypersensitivity to the drug can be manifested by rash, itching, as well as fever and chills, edema, rarely - serum sickness and anaphylactic shock.
Hematopoietic system - with prolonged treatment with high doses of Ceftriaxone in the peripheral blood, leukopenia, a decrease in the level of platelets, neutrophils, prolongation of prothrombin time, and rarely, hemolytic anemia can be observed.
On the part of the digestive system, nausea and vomiting, an increase in the level of liver enzymes in the blood, pseudomembranous colitis can be observed. As with almost any antibiotic therapy, the normal intestinal microflora suffers, which leads to the abundant reproduction of fungi of the genus Candida.
Reactions from the genitourinary system may take the form of an increase in the content of nitrogen and urea in the blood, very rarely interstitial nephritis, colpitis may develop.

Side effects on the central nervous system can be manifested by headache or dizziness.

There are a lot of described side effects from Ceftriaxone injections, but it should also be remembered that due to the low toxicity of the drug, they develop quite rarely.

Indications and contraindications for use

There are a lot of diseases caused by microorganisms sensitive to Ceftriaxone:

Bacterial infections of the upper and lower respiratory tract, as well as ENT organs (lung abscess, bronchitis, pneumonia, pleurisy, sinusitis.)
Uncomplicated gonorrhea
Bacterial lesions of the skin and appendages
Diseases of the urinary tract and genitourinary system (cystitis, prostatitis, acute and chronic pyelonephritis)
Gynecological infections, as well as inflammatory lesions of the pelvic organs.
Bacterial lesions of the abdominal organs (cholecystitis, pancreatitis, duodenitis)
Sepsis and septicemia
Bacterial diseases of bones and joints
Inflammation of the meninges (meningitis)
Endocarditis
Syphilis
Lyme disease (Lyme boreliosis.

Ceftriaxone is also used to prevent purulent-septic complications after surgical interventions.

Contraindications:

The drug is contraindicated if allergic reactions have already been observed to Ceftriaxone itself, other cephalosporins, as well as to any other beta-lactam antibiotics (due to possible cross-allergy) - carbapenems, monobactams, penicillins. Ceftriaxone is considered relatively safe when used in pregnant women, although adequate studies of its effect on the fetus have not been conducted.
The use of the drug in pregnant women is possible after the first trimester, and only if the expected benefit from the administration of Ceftriaxone is higher than the possible harm to the fetus. If Ceftriaxone is prescribed during lactation, it is recommended to stop breastfeeding, since a small amount of the drug is excreted together with breast milk.
In laboratory conditions, data have been obtained on the ability of Ceftriaxone to displace bilirubin from carrier proteins in blood plasma, so the use of the drug in children with hyperbilirubinemia (especially in premature infants) requires special care.
In patients with a combination of severe hepatic and renal insufficiency, as well as in patients regularly undergoing hemodialysis, regular determination of the concentration of Ceftriaxone in the blood is recommended.
Ceftriaxone has relatively few contraindications for use, but nevertheless, the decision on the need for antibiotic therapy with this particular drug should be made by a specialist with the appropriate education.

How to use Ceftriaxone

One of the features of the drug - the absence of tablet forms for oral administration is a consequence of low bioavailability during enteral use, as well as a negative effect on the mucous membranes of the hollow organs of the digestive system. That is why Ceftriaxone is produced only in the form of a powder, from which solutions are prepared for intramuscular or intravenous administration.

Ready solution for intravenous administration is recommended to be used immediately after preparation. The finished solution for intramuscular injection can be stored at room temperature for up to 3 days, and in the refrigerator (subject to the temperature regime of + 4 ° C) for up to 10 days. During storage, the Ceftriacone solution may change its color from light yellow to amber, but if stored correctly, the drug can still be used.

Preparation of solutions

For intramuscular administration. Ceftriaxone, when administered intramuscularly, causes quite severe pain, as a result of which the solution is prepared using 1% Lidocaine. A dose of Ceftriaxone up to half a gram should be dissolved in 2 ml of a 1% solution of Lidocaine, for 1 g of an antibiotic you will need 3.5 ml of a local anesthetic. It is not advisable to inject more than 1 g of the solution into one muscle.

For injection into a vein. In order to prepare a solution from half a gram of an antibiotic, 5 ml of water for injection is needed, 10 ml should be used for 1 gram. The resulting solution is administered over two to four minutes.

For infusion use. 2 g of Ceftriaxone should be dissolved in 40 ml of saline, or in 40 ml of 5% or 10% glucose. If the prescribed dose of Ceftriaxone exceeds 50 mg per 1 kilogram of body weight, Ceftriaxone solution is administered drip for at least half an hour.

More detailed information on how to dilute the drug can be obtained by watching the video:

Ceftriaxone is popular with doctors of many specialties for a reason - the combination of low toxicity of the drug with a fairly high efficiency, resistance to bacterial penicillinases, as well as the ability of an antibiotic to penetrate into all tissues and body fluids are rarely combined in one remedy.

But, despite the safety of the drug, you should not use antibacterial drugs on your own, because it is precisely because of the uncontrolled use of antibiotics that some bacteria have already developed resistance to Ceftriaxone.

· Reading: 6 min · Views:

A modern pharmacological agent with a pronounced antibacterial activity is Ceftriaxone injections. What is the benefit of this antibiotic? The drug is referred by experts to a subgroup of cephalosporins of the latest generation. The drug has the broadest bactericidal effect, therefore it is active against a variety of aerobic as well as anaerobic pathogenic microorganisms. The drug "Ceftriaxone" instructions for use suggests using it for epiema, borreliosis, pyelonephritis.

Main cast

According to the international classification, Ceftriaxone is an antibacterial agent from the class of cephalosporins, however, it is from the 3rd class of medicines, which have a more powerful effect and a smaller range of side effects.

Pharmacological agent is a weakly hygroscopic powder of fine crystalline structure. With a yellowish or whitish tint. The main substance is the sodium salt of ceftriaxone. Auxiliary components only support and enhance the healing properties of the active ingredient.

In what form can

In the pharmacy network at the moment, a pharmacological agent in the following forms:

powder for further preparation of injection solutions - 0.25 g, or 0.5 g, as well as 1 g or 2 g;
powder for preparation of infusion solutions.

The drug in tablets or syrup is not produced by the manufacturer.

Available pharmacological effects

Since the agent is a semi-synthetic antibacterial drug from the subgroup of cephalosporins of the latest generation, its maximum bactericidal activity is guaranteed due to the powerful suppression of the activity of cell membranes of pathogenic microorganisms. At the same time, the drug has optimal resistance to the effects of beta-lactamase.

The agent exhibits the widest activity in suppressing both gram-positive and gram-negative flora.

Injections "Ceftriaxone": what helps and when prescribed

The instructions for the Ceftriaxone medication attached to each pack indicate that the remedy can provide effective assistance in infectious lesions formed due to drug-sensitive pathogens.

Ceftriaxone injection solution prepared from their powder is recommended for antibacterial treatment:

pathologies of the abdominal region - for example, gallbladder empyema, severe peritonitis;
infections of the ENT organs or respiratory structures - empyema of the pleural tissue, or bronchitis, or croupous pneumonia, as well as an abscess of the lung parenchyma;
various infections of bone structures and articular elements, as well as soft tissues and dermis, urogenital structures - pyelonephritis, or pyelitis, or prostatitis, cystitis, and also epididymitis;
epiglottis;
the resulting infection of burn, wound surfaces;
various lesions of the pathogenic flora of the maxillofacial structures;
severe septicemia of bacterial etiology;
endocarditis and meningitis of a bacterial nature;
tick-borne type borreliosis;
an uncomplicated form of gonorrhea, including in cases where the pathology is provoked by microorganisms that secrete penicillinase;
salmonellosis, as well as an inactive form of carriage;
typhoid fever.

It is possible to use the drug for preoperative prophylaxis, as well as for the treatment course in patients with immunodeficiency status.

Main contraindications

According to the instructions for the drug "Ceftriaxone", the use of the drug is prohibited under the following conditions:

with existing UC;
failures in the functionality of the renal and hepatic structures;
with individual hyper-susceptibility to active and auxiliary substances of the drug "Ceftriaxone", from which injections can cause side effects;
with enteritis, colitis;
in neonates with hyperbilirubinemia.

At the time of bearing the baby, the use of the medication is possible with individual indications, but under the strict supervision of a specialist. During lactation, the pharmacological agent requires the cessation of breastfeeding the baby. Taking the medicine with alcoholic products is not compatible, therefore, it is recommended to refuse it for the entire period of treatment with the medicine.

The drug "Ceftriaxone": instructions for use and dosing

The pharmacological agent is intended for parenteral administration - for adults and adolescents over 10-12 years old, the dose will be 0.5-1 g every 12-14 hours or 1-2 g / day. The maximum dose per day - should not be more than 4 g.

For crumbs of the first two weeks after birth, the dose should be 20-50 mg / kg per day. For children of the older age category - up to 12-14 years old, the dose is not more than 20-80 mg / kg. For children weighing over 50 kg, the dose is calculated as for adults.

It is necessary to count on an infusion dose of more than 50 mg / kg - in 25-30 minutes. The total duration of the treatment course will depend on the diagnosed severity of the pathology. For example, with bacterial meningitis in infants and children of the younger category, the dose will be 100 mg / kg once. The dose per day is not more than 4 g. The total duration of the treatment course directly depends on the identified pathogen.

In order to optimally prevent complications after surgery, the medication is administered once at a dose of 1-2 g, in direct proportion to the risk of infection - 30-90 minutes before surgery. If surgical manipulation on intestinal loops is to be performed, the administration of a drug from the subgroup of 5-nitroimidazoles is also recommended.

With diagnosed gonorrhea, the dose is calculated as 250 mg / m - once a day. In severe pathologies of an infectious nature of a different localization - at a dose of 25-37.5 mg / kg every 12-14 hours. In pediatric practice, for infectious defects of the dermis, the drug is recommended at a dose of 50-75 mg / kg per day, once, or 25-37.5 mg / kg every 10-12 hours, but not more than 2 g / day.

With a diagnosed middle variant of otitis media, the drug is administered parenterally, intramuscularly, at a dose of 50 mg / kg. In people with impaired renal structures, the dose is adjusted in case of decompensation, it should not exceed 2 g.

How to prepare a solution

Experts point out that solutions for the parenteral route of administration of the drug must be prepared shortly before the moment of application. For example, for intramuscular delivery of a drug into the body, 500 mg of the powder form of the drug is dissolved in 2 ml, and 1 g of the drug is dissolved in 3.5 ml of 1% lidocaine. Dilution of the drug is carried out only with a sterile liquid for injection. However, the introduction will be somewhat more painful.

The solution for infusion "Ceftriaxone" is prepared in this way: 2 g of the drug is dissolved in 40 ml either in isotonic sodium chloride liquid, or 5% levulose, or 5% dextrose. The drug in the amount of 50 mg / kg and more is recommended for infusion delivery to the human body, drip, for about 25 - 30 minutes. Freshly prepared solutions are physically and chemically stable for no more than 5.5 - 6 hours at room temperature.

With the intravenous route of administration of the drug, 500 mg of the powder is dissolved in 5 ml, and 1 g in 10 ml in a sterile injection liquid. Then the finished solution is injected slowly, about 2.5-4 minutes.

Possible negative effects

Like most pharmaceuticals, the drug "Ceftriaxone" has a number of undesirable effects:

persistent headaches;
previously uncharacteristic dizziness;
failure in the activity of renal structures;
oliguria;
hematuria;
glycosuria;
hypercreatinemia;
dyspeptic disorders;
taste disorders;
severe flatulence;
stomatitis and glossitis;
severe dysbacteriosis;
gastralgia;
disorders in the circulatory system;
tendency to nosebleeds;
various allergic conditions, for example, urticaria, bronchospasm.

Of the local negative reactions, the instructions indicate phlebitis, severe pain along the vein, pain in the thickness of the gluteal muscle.

Analogues of the drug "Ceftriaxone"

According to the composition, the following analogues are distinguished:

"Azaran".
"Cefogram".
"Axon".
"Ceftriaxone-KMP".
"Longacef".
Movigip.
Oframax.
"Toroceph".
"Rocefin".
"ceftriabol".
"Tercef".
Lifaxon.
"Ceftriaxone-Vial".
"Forcef".
Megion.
"Stericef".
"Cefson".
"Lendatsin".
"Biotraxon".
"Cefaxon".
"Betasporin".
"Medaxon".
"Ceftriaxone Elfa".
"Chizon".
"Ceftriaxone-AKOS".
Triaxon.
"Ceftriaxone sodium salt".
"Cefatrin".

Price

Powder for the preparation of injections "Ceftriaxone" can be bought in pharmacies in Moscow and other regions of Russia at a price of 23 rubles. In Minsk, it costs 5-15 bel. rubles. The price of the drug in Kiev reaches 58 hryvnia, in Kazakhstan - 140 tenge.

Reviews

In most reviews posted on forums dedicated to the discussion of antibacterial drugs, Ceftriaxone is described as a potent drug that can provide effective assistance in the fight against various pathologies of a bacterial nature. In addition, the drug is acceptable by experts for use in infants, as well as pregnant women. However, in some reviews, patients indicate unpleasant soreness when the medication is administered.

Characteristics of the drug

It is a third generation cephalosporin antibiotic. It has a wide spectrum of activity against many strains of virulent microorganisms. In the inflammatory process of infectious genesis, the antibiotic group is selected individually according to the results of bakposev. The analysis determines which type of antimicrobial agents the bacteria are less resistant to. The appointment of Ceftriaxone is indicated in case of need for urgent treatment, when there is no time to wait for the results of bacterial culture.

Ceftriaxone contains the active substance of the same name, the action of which is to destroy the membrane of microbial cells. This leads to the death of microorganisms. Ceftriaxone treats diseases caused by many gram-negative and gram-positive microorganisms, aerobic and anaerobic bacteria. It depresses life:

streptococci;
staphylococci;
coli;
Pseudomonas aeruginosa;
clubsiella;
macrocells;
protea.

Ceftriaxone is for injection only., which many patients do not like, especially children, because it causes pain when injected. It is possible that tablets will be produced soon, but there is no such dosage form at this time. Injections help relieve the symptoms of the disease in 2-3 days, since they have high bioavailability and the ability to concentrate the active substance in places where the infection accumulates.

When applied

Ceftriaxone is treated with any pathological process caused by the above virulent microorganisms.

The medicine is used for:

sepsis;
pneumonia;
respiratory diseases;
pathologies of the abdominal organs;
infections of the skeletal system;
peritonitis;
meningitis.

Ceftriaxone injections help to cure sexually transmitted diseases (gonorrhea, syphilis), as well as diseases of the urinary system (pyelonephritis). The drug helps with emphyema of the gallbladder or pleura, cholagitis. Ceftriaxone is often used to prevent postoperative infection in immunocompromised patients.

The use of the drug is contraindicated during pregnancy. A doctor may prescribe injections to a pregnant woman to treat an acute pathological process or a complicated form. This takes into account the ratio: how much the medicine will help and the harm done by the drug. With caution, it should be injected in people with impaired renal excretory function, since the drug can cause the formation of sand in the urinary system.

Ceftriaxone is injected for 3 to 14 days, depending on the severity of the pathology. The course of therapy is set by the doctor, based on the patient's condition. Even if the signs of the disease have passed, it is necessary to be treated with Ceftriaxone for another 2-3 days. This will fix the result, completely destroy pathogenic microbes. Before treatment, the patient must be sure to test the tolerance of this drug and its solvent ("Lidocaine"). If the patient is allergic to the components of the drug, then the doctor replaces it with an analogue that does not cause an undesirable reaction.

In any case, before starting treatment with Ceftriaxone, you need to visit a doctor, since this is a strong antibiotic that has many contraindications and adverse reactions.

Found an error? Select it and press Ctrl + Enter

The medicine contains ceftriaxone- an antibiotic from the class of cephalosporins (β-lactam antibiotics, the chemical structure of which is based on 7-ACC).

What is Ceftriaxone?

According to Wikipedia, ceftriaxone is antibiotic, the bactericidal effect of which is due to its ability to disrupt the synthesis of peptidoglycan of bacterial cell walls.

The substance is a slightly hygroscopic fine-crystalline powder of yellowish or white color. One bottle of the drug contains 0.25, 0.5, 1 or 2 grams of sterile ceftriaxone sodium salt.

Release form

Powder 0.25/0.5/1/2 g for preparation:

solution for and;
solution for infusion therapy.

Ceftriaxone is not available in tablets or syrup.

pharmachologic effect

Bactericidal. III generation drug from the group of antibiotics "Cephalosporins".

Pharmacodynamics and pharmacokinetics

A universal antibacterial agent, the mechanism of action of which is due to the ability to inhibit the synthesis of the bacterial cell wall. The drug exhibits greater resistance to most β-lactamase Gram (+) and Gram (-) microorganisms.

Active against:

Gram (+) Aerobes - St. aureus (including penicillinase-producing strains) and Epidermidis, Streptococcus (pneumoniae, pyogenes, viridans group);
Gram (-) aerobes - Enterobacter aerogenes and cloacae, Acinetobacter calcoaceticus, Haemophilus influenzae (including penicillinase-producing strains) and parainfluenzae, Borrelia burgdorferi, Klebsiella spp. (including pneumoniae), Escherichia coli, Moraxella catarrhalis and diplococci of the genus Neisseria (including penicillinase-producing strains), Morganella morganii, Proteus vulgaris and Proteus mirabilis, Neisseria meningitidis, Serratia spp., some strains of Pseudomonas aeruginosa;
anaerobes - Clostridium spp. (exception - Clostridium difficile), Bacteroides fragilis, Peptostreptococcus spp..

In vitro (clinical significance remains unknown) activity is noted against strains of the following bacteria: Citrobacter diversus and freundii, Salmonella spp. (including against Salmonella typhi), Providencia spp. (including against Providencia rettgeri), Shigella spp.; Bacteroides bivius, Streptococcus agalactiae, Bacteroides melaninogenicus.

Resistant to methicillin Staphylococcus, many strains of Enterococcus (including Str. faecalis) and group D Streptococcus (including ceftriaxone) are resistant.

Pharmacokinetic parameters:

bioavailability - 100%;
T Cmax with the introduction of Ceftriaxone in / in - at the end of the infusion, with the introduction of intramuscularly - 2-3 hours;
connection with plasma proteins - from 83 to 96%;
T1 / 2 with intramuscular injection - from 5.8 to 8.7 hours, with intravenous administration - from 4.3 to 15.7 hours (depending on the disease, the patient's age and the condition of his kidneys).

In adults, the concentration of ceftriaxone in the CSF with the introduction of 50 mg / kg after 2-24 hours is many times higher than the MIC (minimum inhibitory concentration) for the most common pathogens meningococcal infection. The drug penetrates well into the cerebrospinal fluid during inflammation of the meninges.

Ceftriaxone is displayed unchanged:

kidneys - by 33-67% (in newborn babies, this figure is at the level of 70%);
with bile to the intestine (where the drug is inactivated) - by 40-50%.

Hemodialysis is ineffective.

Indications for use of Ceftriaxone

The annotation indicates that indications for the use of Ceftriaxone are infections caused by bacteria sensitive to the drug. Intravenous infusions and injections of drugs are prescribed for the treatment of:

infections of the abdominal cavity (including with empyema of the gallbladder, angiocholitis, peritonitis), ENT organs and respiratory tract ( pleural empyema, pneumonia, bronchitis, lung abscess etc.), bone and articular tissue, soft tissues and skin, urogenital tract (including pyelonephritis, pyelitis, prostatitis, cystitis, epididymitis);
epiglottitis;
infected burns/wounds;
infectious lesions of the maxillofacial region;
bacterial septicemia;
sepsis;
bacterial endocarditis;
bacterial meningitis;
syphilis;
chancroid;
tick-borne borreliosis(Lyme disease);
uncomplicated gonorrhea(including in cases where the disease is caused by microorganisms that secrete penicillinase);
salmonellosis/salmonellosis;
typhoid fever.

The drug is also used for perioperative prophylaxis and for the treatment of patients with weakened immunity.

What is ceftriaxone used for for syphilis?

Although in various forms syphilis drug of choice is penicillin, its effectiveness may be limited in some cases.

For use cephalosporin antibiotics resorted to as a backup option for drug intolerance penicillin groups.

Valuable properties of the drug are:

the presence in its composition of chemicals that have the ability to suppress the formation of cell membranes and mucopeptide synthesis in the walls of bacterial cells;
the ability to quickly penetrate into the organs, fluids and tissues of the body and, in particular, into liquor, which in patients with syphilis undergoes many specific changes;
possibility of use for the treatment of pregnant women.

The drug is most effective in cases where the causative agent of the disease is Treponema pallidum, since a distinctive feature of Ceftriaxone is its high treponemocidal activity. The positive effect is especially pronounced with the / m administration of the drug.

Treatment syphilis with the use of the drug gives good results not only in the early stages of the development of the disease, but also in advanced cases: neurosyphilis, as well as in secondary and latent syphilis.

Since the T1 / 2 of Ceftriaxone is approximately 8 hours, the drug can be equally successfully used in both inpatient and outpatient treatment regimens. It is sufficient to administer the drug to the patient once a day.

For preventive treatment, the agent is administered for 5 days, with primary syphilis- 10-day course, early latent and secondary syphilis treated within 3 weeks.

For unopened forms neurosyphilis for 20 days, the patient is administered a single dose of 1-2 g of Ceftriaxone, in the later stages of the disease, the drug is administered at a dose of 1 g / day. for 3 weeks, after which an interval of 14 days is maintained and treatment is carried out for 10 days with a similar dosage.

With acute generalized meningitis and syphilitic meningoencephalitis the dose is increased to 5 g / day.

Ceftriaxone injections: why is the drug prescribed for angina in adults and children?

Though antibiotic effective for various lesions nasopharynx(including when sore throat and at sinusitis), as a rule, it is rarely used as a drug of choice, especially in pediatrics.

At sore throat the medicine can be administered through a dropper into a vein or in the form of conventional injections into a muscle. However, in the vast majority of cases, the patient is prescribed intramuscular injections. The solution is prepared immediately before use. The finished mixture at room temperature remains stable for 6 hours after preparation.

Children with sore throat Ceftriaxone is prescribed in exceptional cases when acute tonsillitis complicated by severe suppuration and inflammation.

The appropriate dosage is determined by the attending physician.

During pregnancy, the drug is prescribed in cases where it is not effective. antibiotics of the penicillin group. Although the drug crosses the placental barrier, it does not significantly affect the health and development of the fetus.

Treatment of sinusitis with ceftriaxone

At sinusitis Antibacterial agents are first line drugs. Completely penetrating into the blood, Ceftriaxone lingers in the focus of inflammation in the right concentrations.

As a rule, the drug is prescribed in combination with mucolytics, vasoconstrictors etc.

How to inject the drug with sinusitis? Usually, the patient is prescribed Ceftriaxone to be injected into the muscle twice a day, 0.5-1 g each. Before injection, the powder is mixed with Lidocaine(preferably use a 1% solution) or d/i water.

Treatment lasts at least 1 week.

Contraindications

Ceftriaxone is not prescribed for known hypersensitivity to cephalosporin antibiotics or auxiliary components of the drug.

Relative contraindications:

neonatal period if the child has hyperbilirubinemia;
prematurity;
renal/liver failure;
enteritis, NUC or colitis associated with the use antibacterial agents;
pregnancy;
lactation.

Side effects of ceftriaxone

Side effects of the drug appear as:

hypersensitivity reactions - eosinophilia, fever, pruritus, hives, edema, skin rash, multiforme (in some cases, malignant) exudative erythema,serum sickness, anaphylactic shock, chills;
headache and dizziness;
oliguria;
digestive disorders (nausea, vomiting, flatulence, taste disorder, stomatitis, diarrhea, glossitis, sludge formation in the gallbladder and pseudocholelithiasis, pseudomembranous enterocolitis, dysbacteriosis, candidomycosis and other superinfections);
disorders of hematopoiesis anemia, including hemolytic;lympho-, leuko-, neutro-, thrombocytopenia, granulocytopenia; thrombo- and leukocytosis,hematuria, basophilia nosebleeds).

If the drug is administered intravenously, inflammation of the venous wall is possible, as well as pain along the vein. The introduction of the drug into the muscle is accompanied by pain at the injection site.

Ceftriaxone (shots and IV infusion) may also affect laboratory values. The patient decreases (or increases) prothrombin time, increases the activity of alkaline phosphatase and liver transaminases, as well as the concentration of urea, develop hypercreatininemia, hyperbilirubinemia, glycosuria.

Ceftriaxone ® is a 3rd generation bactericidal antibiotic. The drug is characterized by prolonged action and high efficiency against most gram-negative and gram-positive pathogens, including strains that secrete penicillinases and cephalosporinases.

The price depends on the manufacturer. Russian Ceftriaxone ® , regardless of the manufacturer, belongs to inexpensive antibiotics. For example, an ampoule (1 g) produced by the pharmaceutical company Sintez AKOMP ® will cost the buyer 27 rubles, Biochemist ® Saransk - 29 rubles, and Lecco ® - 36 rubles.

Swiss Ceftriaxone ® produced by the pharmaceutical company Hoffmann la Roche ® costs about 550 rubles per ampoule.

It has a powerful bactericidal activity and an ultra wide spectrum of antimicrobial effects. The mechanism of antibacterial action of Ceftriaxone ® is realized through active acetylation of membrane-bound transpeptidases, leading to destabilization of the cross-linking of reference polymers in the bacterial cell. Violation of the strength of the membrane leads to rapid cell death.

It should be noted that the drug is able to overcome the placental barrier, so Ceftriaxone ® during pregnancy is not recommended to be administered in the 1st trimester. During lactation, up to four percent of the antibiotic concentration in the blood can be excreted along with breast milk.

The necessary bactericidal parameters in the blood are achieved 1.5 hours after administration. Since the drug has a prolonged action, the minimum antimicrobial concentration in the body is maintained in the blood during the day, which allows it to be administered once a day. However, in case of severe infection or high risk of complications, it is preferable to divide the daily dose into 2 injections. This allows higher bactericidal concentrations to be maintained. Also, you should divide the daily dose into 2 times when prescribing high doses.

In patients older than seventy-five years, the elimination period is prolonged due to the age-related decline in renal function. In this regard, it may be necessary to adjust the prescribed dose. It is preferable to administer the daily dose in such patients at one time.

The excretion of this drug from the body is carried out mainly with urine. Part of the drug is disposed of with bile.

Pharmacological group

The drug belongs to the third generation cephalosporin antibiotics.

Ceftriaxone ® - release form

It has only an injection form of release. The antibiotic is sold in pharmacies, by prescription.

The pharmacological group of ceftriaxone is third-generation parenteral, that is, it can only be used intramuscularly or intravenously. Sold in ampoules of 500, 1000 and 2000 mg. Rocephin is available in an additional dosage of 250 mg.

Photo ceftriaxone ® Kabi 1000 mg powder for solution for intravenous and intramuscular administration

Ceftriaxone ® prescription in Latin

Ceftriaxone ® in Latin is Ceftriaxoni.

Rp.: Ceftriaxoni 1.0

S. In the supplied IM diluent, once a day.

Ceftriaxone ® - composition of the drug

The antibiotic is produced in the form of sodium salt. The active substance, ceftriaxone, easily penetrates into body fluids and media, accumulates significantly in inflamed tissues. With inflammation of the meninges, the antibiotic can accumulate in the cerebrospinal fluid.

Rofecin ® - in the form of a disodium derivative (disodium hydrate). Each ampoule of Rofecin ® is completed with a solvent (lidocaine or injection water).

What does ceftriaxone ® help with?

The antibiotic has an ultra-wide spectrum of antimicrobial activity, covering staphylococci, pneumococci, citrobacter, most strains of Enterobacter, Escherichia coli, Ducray's bacillus, Haemophilus influenzae, Klebsiella, Moraxella, gonococci, meningococci, Proteus, Salmonella, Serration, Shigella, Yersinia, some Clostridia and Fusobacteria , peptococci, peptostreptococci, white treponema.

Methicillin-resistant staphylococci, some enterococci, listeria, bacteroids and clostridium deficille have absolute resistance to Ceftriaxone ®.

Ceftriaxone ® - indications for use

An antibiotic can be used for:

bacterial lesions of the OBP (abdominal organs). May be prescribed for the treatment of abscess, phlegmon, empyema of the gallbladder, bacterial inflammation of the bile ducts, peritonitis, etc.;
infections of the ENT - organs and respiratory organs. systems (including complicated ones, lung tissue abscesses, pleural empyema);
carriage of salmonella and;
typhoid fever;
osteomyelitis, septic arthritis, ;
bacterial lesions of the skin and pancreas, including burns complicated by bacterial flora, etc.;
Lyme disease;
infectious pathologies of the genitourinary system (including gonorrhea, soft chancre, syphilis);
endocarditis;
generalization of infection (development of sepsis);
infections, in patients with;
preventive therapy before surgical intervention on the OBP and pelvic organs.

Ceftriaxone ® - contraindications

An allergy to the drug or other beta-lactam antibiotics is an absolute contraindication. This is due to the fact that among all beta-lactams there is a risk of cross-allergic reactions.

Also, it is not prescribed in the 1st trimester of pregnancy and women who are breastfeeding.

Considering the mechanism of utilization (urine and bile), wed-in can be prescribed for kidney or liver dysfunction, but is not used for combined renal and hepatic insufficiency.

The drug is contraindicated in premature infants less than 41 weeks of age, taking into account the gestational age and age after birth. It is also contraindicated in newborns with hyperbilirubinemia.

Against the background of antibiotic treatment, it is forbidden to administer intravenous calcium solutions, as there is a risk of the formation of a precipitate of the Ca salt of Ceftriaxone ® .

The remedy can be prescribed to children from the first days of life, however, up to two weeks of life it can be used only for health reasons. This is due to its ability to displace bilirubin from its association with serum albumin. This can lead to the development of hyperbilirubinemia and cause kernicterus.

Given the partial utilization with bile, the drug is not prescribed to patients with obstruction of the biliary tract.

An antibiotic on lidocaine is not administered to children under 12 years of age.

Also, it must be taken into account that lidocaine is contraindicated in women who are pregnant, breastfeeding, patients with atrioventricular block, heart failure (heart failure), SVC or Stokes-Adams syndrome, sinus node weakness, complete transverse block, severe bradyarrhythmia, or marked decrease in pressure.

Ceftriaxone ® - Dosage

Introduced intravenously in 10 ml of physical. solution 0.9%. The drug must be administered slowly, over two to four minutes.

Intramuscularly it is administered on lidocaine, physical. solution, water for injection. V / m is not recommended to enter more than a gram. Higher dosages are prescribed in / in.

After 12 years, 1 g Wed is administered 1-2 times a day. In severe cases of the disease, a maximum of four grams per day can be administered (twice, with an interval of 12 hours).

Babies under the age of 2 weeks of life are prescribed 20-50 mg / kg per day for 1 administration.

Bacterial meningitis is an indication for 100 mg/kg of the drug per day during initial therapy. In the future, the dose is reduced.

From 14 days to 12 years 20-80 mg/kg per day. If the child weighs more than 50 kg, it is necessary to prescribe adult doses.

For patients with kidney pathologies, the dose is reduced in accordance with the GFR. Liver dysfunction is also an indication for a reduction in the daily dose.

How many times a day should Ceftriaxone ® be injected for an adult?

The drug is administered 1-2 times a day. In severe infections, the risk of complications, the appointment of high doses of the drug, as well as the presence of an immunodeficiency in the patient, it is preferable to divide the daily dose into two injections.

Ceftriaxone ® side effects

The antibiotic is generally well tolerated by patients. However, the risk of developing allergic reactions should be taken into account. They can have varying degrees of severity from redness and rash at the injection site, urticaria, to Quincke's edema or anaphylactic shock.

The risk of anaphylaxis increases with the introduction of lidocaine ® . Therefore, when appointing a sr-va, a test is mandatory. Also, contraindications and restrictions to the use of lidocaine are taken into account.

It is forbidden to self-administer the drug, adjust the dosage and duration of treatment. Therapy should be carried out in stationary conditions, under the supervision of the attending physician.

Other undesirable effects may be manifested by dyspeptic reactions, diarrhea, phlebitis at the injection site, dysbacteriosis, thrush, changes in the KLA and biochemical analysis. Coagulation disorders are rare (the antibiotic inhibits the intestinal microflora that synthesizes vitamin K) and, as a rule, is characteristic of patients receiving antiplatelet therapy.

In rare cases, antibiotic-associated diarrhea may develop.

Ceftriaxone ® during pregnancy and breastfeeding

The antibiotic is able to overcome the placental barrier, but does not have embryotoxic and teratogenic effects. Ceftriaxone ® during pregnancy is not recommended for administration in the first trimester, as there is insufficient data on its safety in this category of patients. Controlled animal studies have not shown toxic effects on the fetus, so antibiotics can be used in the 2nd and 3rd trimester.

Ceftriaxone ® during lactation can be excreted in breast milk, therefore, when it is prescribed to women who are breastfeeding, a temporary cessation of natural feeding is recommended. This is due to the fact that the antibiotic excreted with breast milk can cause sensitization of the baby, the development of oral thrush and intestinal dysbacteriosis.

Ceftriaxone ® and alcohol - compatibility

Ceftriaxone ® and alcohol are categorically incompatible. First, given that the medium is partially utilized by the liver, such a combination can lead to the development of jaundice and drug-induced hepatitis.

Secondly, the use of alcoholic beverages against the background of antibiotic therapy can cause severe intoxication and toxic damage to the kidneys.

Thirdly, this can lead to the development of a severe disulfiram-like reaction. It can be manifested by tachycardia, chills, tremor of the extremities, convulsions, cardiac arrhythmias, arterial hypotension, up to collapse.

Allergy to Ceftriaxone ®

It is not prescribed to patients with allergies to other beta-lactams, due to the high risk of developing an allergic cross-reaction.

Also, before the introduction, it is always necessary to put a sample.

Allergic manifestations can vary from urticaria to anaphylaxis (in the absence of timely medical care, death is possible).

Deaths have been associated with its dilution and administration with lidocaine. Given the risk of anaphylactic shock, self-treatment with an antibiotic is strictly prohibited. The drug should be used exclusively in a hospital, after setting the sample.

The drug diluted with lidocaine ® is administered only intramuscularly, intravenous administration is strictly contraindicated.

When administered intramuscularly, 250 or 500 mg is diluted in two ml of 1% lidocaine ® . One gram of antibiotic is diluted with 3.5 milliliters of 1% lidocaine ® .

If 2% lidocaine ® is used, injectable water should be used additionally. With the introduction of 250 and 500 ml of the antibiotic, it is diluted with 1 ml of lidocaine ® (2%) and 1 ml of water for injection. One gram of antibiotic is diluted with 1.8 ml of lidocaine ® + 1.8 ml of injection water.

Can ceftriaxone ® be diluted with novocaine?

Recent studies have shown that the drug should not be diluted with novocaine for administration. Its use is associated with the risk of anaphylaxis. It also reduces the activity of cephalosporin and relieves pain worse than lidocaine®.

Ceftriaxone ® injections - reviews of doctors

The drug has repeatedly proven its effectiveness in the treatment of infections of the upper respiratory tract and respiratory organs. system, infections of the OBP, skin, etc.

However, it must be remembered that the remedy should be used only as directed and under the supervision of a physician. This will reduce the risk of developing unwanted effects.

Patients note a rapid and persistent onset of improvement. Negative reviews of the drug are most often associated with its pain when administered intramuscularly.

Instructions for use:

Ceftriaxone is a 3rd generation cephalosporin.

Composition and dosage form of Ceftriaxone

The drug is produced in the form of a powder for preparing a solution in 1 g glass vials containing the active substance - ceftriaxone 1 g.

pharmachologic effect

According to the instructions, Ceftriaxone is a semi-synthetic antibiotic belonging to the 3rd generation cephalosporins. The drug is resistant to the action of beta-lactamase, as well as gram-negative and gram-positive microorganisms. It has a broad bactericidal action.

Indications for use

Ceftriaxone according to the instructions is prescribed for such infectious and inflammatory diseases as:

wound infections;

Infectious diseases of the skin and soft tissues;

Meningitis;

Infectious diseases in immunocompromised patients;

Infectious diseases of the joints and bones;

Disseminated Lyme borreliosis in the early and late stages;

Infectious diseases of the abdominal organs (infections of the biliary tract and gastrointestinal tract, peritonitis);

Infectious diseases of the urinary tract and kidneys;

Infectious diseases of the pelvic organs;

Infectious diseases of the ear, throat, nose;

Gonorrhea;

Infectious diseases of the genital organs;

Infectious diseases of the respiratory tract;

The indication for Ceftriaxone is the prevention of infections after surgery.

Contraindications

The use of ceftriaxone is contraindicated in patients with hypersensitivity to cephalosporins.

According to reviews, Ceftriaxone should be prescribed with caution in cases of impaired renal and hepatic function, in UC, in colitis and enteritis caused by taking antibacterial drugs, as well as in newborns with hyperbilirubinemia.

While taking Ceftriaxone, according to indications, it is forbidden to drink alcoholic beverages.

Method of application of Ceftriaxone and dosing regimen

According to the instructions, Ceftriaxone is used for intravenous or intramuscular administration.

Children over 12 years of age and adults are prescribed treatment with Ceftriaxone at a dosage of 1-2 g once a day. In case of especially severe infections, an increase in the daily dosage up to 4 g is allowed.

For newborns under the age of two weeks, the dosage is 20-50 mg per kg of body weight once a day. The maximum daily dosage is 50 mg per kg of body weight.

For infants and children under 12 years of age, the dosage of Ceftriaxone is 20-80 mg per kg of body weight once a day.

For children weighing more than 50 kg, the dosage is calculated as for adults.

Doses of 50 mg per kg of body weight or more when administered intravenously are administered drip for at least half an hour.

The duration of treatment depends on the indications for ceftriaxone. After eradication of the pathogen and normalization of body temperature, treatment with Ceftriaxone should be continued for another 2-3 days.

With bacterial meningitis in infants, the dosage of the drug is 100 mg / kg body weight once a day.

With Lyme borreliosis, children over 12 years of age and adults are prescribed 50 mg per kg of body weight once a day. The duration of treatment with Ceftriaxone is two weeks.

With gonorrhea, Ceftriaxone is effective at a dosage of 250 mg intramuscularly once.

For the prevention of infections in the postoperative period, the drug is administered at a dosage of 1-2 g once an hour and a half before surgery.

Side effects

According to reviews, Ceftriaxone causes the following side reactions:

Allergies: fever or chills, urticaria, eosinophilia, bronchospasm, serum sickness, exudative erythema multiforme, anaphylactic shock, skin rash, itching.

Hematopoietic system: leukopenia, anemia, neutropenia, leukocytosis, thrombocytosis, lymphopenia, hemolytic anemia, thrombocytopenia, hypocoagulation.

Digestive system: flatulence, constipation or diarrhea, nausea, vomiting, abdominal pain, taste disturbance, pseudomembranous enterocolitis, dysbacteriosis, liver dysfunction.

Urinary system: anuria, impaired renal function, oliguria.

Local reactions: with intravenous administration - soreness along the vein, phlebitis, with intramuscular injection - pain at the injection site.

In addition to the above adverse reactions, Ceftriaxone, according to reviews, can cause nosebleeds, dizziness, superinfection, headache, and candidiasis.