Ceftriaxone
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
| Ceftriaxone
| |
| Systematic (IUPAC) name | |
| (6R,7R,Z)-7-(2-(2-aminothiazol-4-yl)- 2-(methoxyimino)acetamido)-3-((6-hydroxy-2-methyl-5-oxo- 2,5-dihydro-1,2,4-triazin-3-ylthio)methyl)-8-oxo-5-thia- 1-aza-bicyclo[4.2.0]oct-2-ene-2-carboxylic acid | |
| Identifiers | |
| CAS number | |
| ATC code | J01 |
| PubChem | |
| DrugBank | |
| Chemical data | |
| Formula | C18H18N8O7S3 |
| Mol. mass | 554.58 g/mol |
| Pharmacokinetic data | |
| Bioavailability | n/a |
| Metabolism | Negligible |
| Half life | 5.8–8.7 hours |
| Excretion | 33–67% renal, 35–45% biliary |
| Therapeutic considerations | |
| Pregnancy cat. | |
| Legal status | |
| Routes | Intravenous, intramuscular |
|
WikiDoc Resources for Ceftriaxone | |
|
Articles | |
|---|---|
|
Most recent articles on Ceftriaxone Most cited articles on Ceftriaxone | |
|
Media | |
|
Powerpoint slides on Ceftriaxone | |
|
Evidence Based Medicine | |
|
Clinical Trials | |
|
Ongoing Trials on Ceftriaxone at Clinical Trials.gov Clinical Trials on Ceftriaxone at Google
| |
|
Guidelines / Policies / Govt | |
|
US National Guidelines Clearinghouse on Ceftriaxone
| |
|
Books | |
|
News | |
|
Commentary | |
|
Definitions | |
|
Patient Resources / Community | |
|
Patient resources on Ceftriaxone Discussion groups on Ceftriaxone Patient Handouts on Ceftriaxone Directions to Hospitals Treating Ceftriaxone Risk calculators and risk factors for Ceftriaxone
| |
|
Healthcare Provider Resources | |
|
Causes & Risk Factors for Ceftriaxone | |
|
Continuing Medical Education (CME) | |
|
International | |
|
| |
|
Business | |
|
Experimental / Informatics | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Overview
Ceftriaxone (INN) (IPA: [kɛfˈtraɪækson, sɛf-]) is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram positive and Gram negative bacteria. In most cases, it is considered to be equivalent to cefotaxime in terms of safety and efficacy. Ceftriaxone sodium is marketed by Hoffman-La Roche under the trade name Rocephin.
Clinical use
Ceftriaxone is often used (in combination, but not direct, with macrolide and/or aminoglycoside antibiotics) for the treatment of community-acquired pneumonia. It is also a choice drug for treatment of bacterial meningitis. In pediatrics, it is commonly used in febrile infants between 4 and 8 weeks of age who are admitted to the hospital to exclude sepsis. It has also been used in the treatment of Lyme disease and gonorrhea.
The usual starting dose is 1 gram IV daily although dosage may be adjusted for body mass in younger patients. Doses range from 1–2 grams IV or IM every 12–24 hours, depending on the type and severity or the infection, up to 4 grams daily. For gonorrhoea the usual adult dose is a single intramuscular injection of 125 mg. Patients treated for gonorrhoea are usually also treated for chlamydia, often with azithromycin. The injection is unusually painful and therefore administered with lidocaine as a local anesthetic. However, individuals who are allergic to lidocaine can expect approximately 1 hour of pain, similar to being forcefully kicked or punched in the site of injection (usually the buttocks). It is not a stinging or burning pain, and it is very intense for about 20 minutes, diminishing over 60 to 180 minutes. Residual discomfort can last 24 hours.
Ceftriaxone is contraindicated in patients with known hypersensitivity to cephalosporins, penicillins and/or carbapenems.
Long term use of ceftriaxone through intravenous route can cause overgrowth of organisms on the surface of the tongue. Monitoring tongue and oral cavity is recommended.
Warnings
FDA notified healthcare professionals of an update to a previous alert that addresses the interaction of ceftriaxone with calcium-containing products, based on previously reported fatal cases in neonates.
At the request of FDA, the manufacturer of ceftriaxone (Roche) conducted two in vitro studies to assess the potential for precipitation of ceftriaxone-calcium when ceftriaxone and calcium-containing products are mixed in vials and in infusion lines.
These two in vitro studies were conducted in neonatal and adult plasma to assess the potential for precipitation of ceftriaxone-calcium using varying ceftriaxone and calcium concentrations, including concentrations in excess of those achieved in vivo.
Based on the results from these studies, FDA now recommends that ceftriaxone and calcium-containing products may be used concomitantly in patients >28 days of age, using the precautionary recommendations noted because the risk of precipitation is low in this population.
FDA had previously recommended, but no longer recommends, that in all age groups ceftriaxone and calcium-containing products should not be administered within 48 hours of one another.
Chemistry
Ceftriaxone is a yellowish-orange crystalline powder which is readily-soluble in water, sparingly soluble in methanol and very slightly soluble in ethanol. The pH of a 1% aqueous solution is approximately 6.7.
The syn-configuration of the methoxyimino moiety confers stability to β-lactamase enzymes produced by many Gram-negative bacteria. Such stability to β-lactamases increases the activity of ceftriaxone against otherwise resistant Gram-negative bacteria. In place of the easily hydrolysed acetyl group of cefotaxime, ceftriaxone has a metabolically-stable thiotriazinedione moiety.
External links
- MedlinePlus Drug Information: Cephalosporins (systemic) – information from USP DI Advice for the Patient
- Rocephin U.S. Prescribing Information
WikiDoc Research Resources for Ceftriaxone | |
|---|---|
| Articles on Ceftriaxone | Most recent articles on Ceftriaxone • Most cited articles on Ceftriaxone • Review articles on Ceftriaxone • Articles on Ceftriaxone in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Ceftriaxone | Powerpoint slides on Ceftriaxone • Images of Ceftriaxone • Photos of Ceftriaxone • Podcasts & MP3s on Ceftriaxone • Videos on Ceftriaxone |
| Evidence Based Medicine Regarding Ceftriaxone | Cochrane Collaboration on Ceftriaxone • Bandolier on Ceftriaxone • TRIP on Ceftriaxone |
| Cost Effectiveness of Ceftriaxone | Cost Effectiveness of Ceftriaxone |
| Clinical Trials Involving Ceftriaxone | Ongoing Trials on Ceftriaxone at Clinical Trials.gov • Trial results on Ceftriaxone • Clinical Trials on Ceftriaxone at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Ceftriaxone | US National Guidelines Clearinghouse on Ceftriaxone • NICE Guidance on Ceftriaxone • NHS PRODIGY Guidance • FDA on Ceftriaxone • CDC on Ceftriaxone |
| Textbook Information on Ceftriaxone | Books and Textbook Information on Ceftriaxone |
| Pharmacology Resources on Ceftriaxone | Dosing of Ceftriaxone • Drug interactions with Ceftriaxone • Side effects of Ceftriaxone • Allergic reactions to Ceftriaxone • Overdose information on Ceftriaxone • Carcinogenicity information on Ceftriaxone • Ceftriaxone in pregnancy • Pharmacokinetics of Ceftriaxone • |
| Genetics, Pharmacogenomics, and Proteinomics of Ceftriaxone | Genetics of Ceftriaxone • Pharmacogenomics of Ceftriaxone • Proteomics of Ceftriaxone |
| Newstories on Ceftriaxone | Ceftriaxone in the news • Be alerted to news on Ceftriaxone • News trends on Ceftriaxone |
| Commentary on Ceftriaxone | Blogs on Ceftriaxone |
| Patient Resources on Ceftriaxone | Patient resources on Ceftriaxone • Discussion groups on Ceftriaxone • Patient Handouts on Ceftriaxone • Directions to Hospitals Treating Ceftriaxone • Risk calculators and risk factors for Ceftriaxone |
| Healthcare Provider Resources on Ceftriaxone | Symptoms of Ceftriaxone • Causes & Risk Factors for Ceftriaxone • Diagnostic studies for Ceftriaxone • Treatment of Ceftriaxone |
| Continuing Medical Education (CME) Programs on Ceftriaxone | CME Programs on Ceftriaxone |
| International Resources on Ceftriaxone | Ceftriaxone en Espanol • Ceftriaxone en Francais |
| Business Resources on Ceftriaxone | Ceftriaxone in the Marketplace • Patents on Ceftriaxone |
| Informatics Resources on Ceftriaxone | List of terms related to Ceftriaxone |
| ||||
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
