Ceftriaxone

Ceftriaxone - a third generation cephalosporin which is similar in many respects to cefotaxime, with enhanced activity against Gram ve species in comparison to second generation cephalosporins. Ceftriaxone is not active against enterococci, MRSA, Pseudomonas aeruginosa or Bacteroides spp. Ceftriaxone has a prolonged serum half-life allowing for once daily dosing. However, twice daily dosing is normally recommended for severe infections including meningitis.

Uses:
Empiric therapy for meningitis
Intra-abdominal infections including peritonitis
Community-acquired or nosocomial pneumonia
Surgical prophylaxis, although first- and second-generation
cephalosporins are usually preferred
Clearance of throat carriage in meningococcal disease

Contraindications:
Hypersensitivity to cephalosporins
Serious penicillin hypersensitivity (10% cross-sensitivity)
Porphyria

Administration:
• IV: 2 g once daily, increased to 2 g 12 hourly in severe infections

Reconstitute 2-g vial with 40 ml of glucose 5% or sodium chloride
0.9% given over at least 30 min

In renal impairment:

CC (ml/min)	Dose (g)	Interval (h)
< 10	2	24

How not to use ceftriaxone:

Not to be dissolved in infusion fluids containing calcium (Hartmann’s)

Adverse effects:

Hypersensitivity

Transient liver enzymes

Clostridium difficile-associated diarrhoea