Ceftriaxone is a third-generation cephalosporin antibiotic with a broad spectrum of action. It inhibits the formation of cell membranes of bacterial cells. Ceftriaxone penetrates the blood-brain barrier, the placenta and partially enters milk.

Treatment of infectious diseases with ceftriaxone

Ceftriaxone is prescribed for (it must be remembered that for diseases caused by viruses, antibiotics are useless) respiratory tract(bronchopnephritis), ENT organs (, sinusitis), urinary system (pyelonephritis, paranephritis), genital organs (adnexitis, gonorrhea), skin (erysipelas), organs abdominal cavity(peritonitis), sepsis, etc.

How to dilute ceftriaxone for injection

Ceftriaxone intramuscularly - how to dilute

Ceftriaxone is diluted for intramuscular administration with a 1% lidocaine solution in a volume of 2-3 ml. or 2% lidocaine solution and water for injection in a 1:1 ratio. The drug powder dissolves quickly without forming sediment or cloudiness. If flakes, crumbs or cloudiness occur, do not use the solution. The adult dosage is on average 1-2 g per day. The drug is administered once (some experts do not recommend injecting more than 1 g of the drug into one gluteal muscle). Children over 12 years old receive adult dosage, and for younger children the dose should be calculated based on weight: 20-80 mg per 1 kg of child weight. The dosage is determined by the doctor when examining the child and assessing the severity of the underlying disease and the risk of complications.

Ceftriaxone intravenously - how to dilute

For intravenous administration do not use lidocaine, as it affects the functioning of the heart. 0.9% saline sodium chloride or water for injection is suitable. The drug should be administered extremely slowly, the best option- This is a drip injection.

Important to remember:

- The solution should be prepared immediately before administration.
- The remaining solution is not used the next day, as it loses sterility.
- The drug should be injected deep into the muscle, therefore for adults 2-3 ml syringes. won't fit. Only 5 ml syringes are acceptable.
- Lidocaine is not used to dilute the drug for intravenous administration.
- Intravenous administration should be carried out extremely slowly, the best option is a drip infusion.
- Do not use other antibiotics or calcium-containing drugs together with ceftriaxone (especially do not dilute the powder with solutions containing calcium).
- As with the use of other antibiotics, you should pay attention to the intestinal microflora: taking Linex, Lactobacterin or systematically eating biokefir is suitable.
- Seals may form at the injection site due to the administration of cold solutions. Local heat (for example, a heating pad) will increase blood flow to the muscle and enhance absorption of the drug.
- The appearance of intense pain at the injection site, sharp increase temperature, the appearance of softening in the center of the compaction is a signal to consult a doctor.

Powerful antibiotic wide range Ceftriaxone is a representative of the 3rd generation of cephalosporins. It has an optimal effect when administered parenterally, but intramuscular injections of this drug are painful and require the use of anesthetics.

Ceftriaxone and Lidocaine are most often used, because this combination provides the best effect.

Action of Ceftriaxone

The drug exhibits an antibiotic effect against many gram-positive and gram-negative pathogens belonging to both anaerobes and aerobic groups, including streptococci and staphylococci, Pseudomonas aeruginosa and Escherichia coli, pathogens of gonorrhea and meningitis. Its antibacterial activity is based on suppressing the synthesis of murein, which is the most important component of the cell membrane of a microorganism, which impairs its strength and leads to the death of the individual.

Ceftriaxone is different high level bioavailability (100% 2 hours after intramuscular injection) and long-lasting action.

It easily penetrates various tissues and fluids, including the cerebrospinal fluid.

What does Lidocaine help with?

Being a 2nd generation anesthetic drug, Lidocaine is used when local anesthesia is necessary in ophthalmology, surgery, during dental procedures, for injection blockade during severe pain and conducting a series diagnostic measures. It is also prescribed to eliminate arrhythmia and is used as a solvent for antibiotics of the cephalosporin group. It works faster, longer and more effectively than Novocaine, but is a more toxic compound. You can find out more about this drug.

Indications for the simultaneous use of Ceftriaxone and Lidocaine

If Ceftriaxone is administered intramuscularly, a strong pain reaction occurs locally. To eliminate painful sensations, use Lidocaine. With intravenous injections, pain may also occur, spreading along the vein. However, in this case, the drug should not be mixed with an anesthetic, since Lidocaine has a strong effect on cardiac activity.

Ceftriaxone is used for diseases the development of which is caused by pathogens susceptible to its action. Indications for use:

• sepsis;
• meningitis;
• salmonellosis;
• defeat respiratory system, including abscess;
• peritonitis, inflammation in the gastrointestinal tract and gallbladder;
• infections urinary tract and genitals;
• osteoarticular and skin diseases;
• infection of soft tissues, wounds, burn injuries.

Antibiotics are also prescribed to treat patients with weak immunity and for the prevention of infection of patients in the postoperative period.

Contraindications

Lidocaine should not be used for hypotension, severe kidney and liver diseases, or allergies to the drug. Caution should be exercised if there are problems with hematopoiesis, as well as when prescribing an anesthetic to pregnant women, nursing mothers, elderly and debilitated patients.

A strict contraindication to the use of Ceftriaxone is individual intolerance to the drug, its analogues, penicillin, or carbapenem antibiotics.

In case of appointment of this medicine newborns with signs of jaundice, premature infants, women during pregnancy or lactation, patients with renal-hepatic abnormalities need to carefully monitor their condition.

How to take Ceftriaxone and Lidocaine

Ceftriaxone is available in powder form. To prepare an injection solution, it can be mixed with saline solution in ampoules or buffer containers, with water for injection or with an anesthetic. WHO recommends Lidocaine as a diluent for cephalosporin antibiotics, including Ceftriaxone. Lidocaine solution is only suitable for intramuscular use.

How to dilute Ceftriaxone with Lidocaine

When preparing a medicinal mixture to administer intramuscularly, the following proportions are observed. If a vial of Ceftriaxone 500 mg is used, its contents are mixed with 1 ampoule of Lidocaine (2 ml). Accordingly, 2 ampoules of anesthetic are consumed for 1 g of antibiotic. You need to purchase a 1% anesthetic component. When using Lidocaine 2%, water is added to it in a 1:1 ratio.

How to prick

An injection is made in the center of the upper outer quadrant of the buttock. The solution must be used fresh, injecting it to a sufficient depth. The medicine is administered slowly. It is not advisable to inject more than 1 g of Ceftriaxone into one buttock.

The daily dosage and duration of the treatment course should be determined by the doctor.

In children, the dose depends on age and body weight. From the age of 12 and weighing over 50 kg, the child is given prescriptions as for an adult.

Side effects of drugs

Lidocaine often provokes the development of typical allergic reactions, and anaphylactic shock is possible. Other side effects are also observed:

• increased heart rate;
• decrease in blood pressure;
• headache;
• increased light sensitivity;
• drowsiness.

Catad_pgroup Antibiotics cephalosporins

Ceftriaxone - instructions for use

Registration number

Trade name of the drug: Ceftriaxone

International nonproprietary 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-azabicyclooct-2-ene-2-carboxylic acid (as disodium salt).

Compound:

One bottle 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 the synthesis cell membrane, 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 under conditions clinical practice Ceftriaxone is usually effective against the following microorganisms:
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 the listed microorganisms, which multiply steadily in the presence of other antibiotics, for example, 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 has good efficacy 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, it is necessary to use disks containing ceftriaxone, 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 body tissues and fluids. In healthy adult subjects, ceftriaxone has a long half-life of about 8 hours. The areas under the concentration-time curve in blood serum after intravenous and intramuscular administration are the same. This means that the bioavailability of ceftriaxone when administered intramuscularly is 100%. When administered intravenously, ceftriaxone quickly diffuses into the interstitial fluid, where it retains its bactericidal effect against pathogens sensitive to it for 24 hours.
The half-life in healthy adult subjects is approximately 8 hours. In neonates up to 8 days and in elderly people over 75 years of age, the average half-life is approximately 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 intestinal flora, ceftriaxone is converted into an inactive metabolite. In newborns, approximately 70% of the administered dose is excreted by the kidneys. In case of renal failure or liver pathology in adults, the pharmacokinetics of ceftriaxone remains almost unchanged, the elimination half-life is slightly extended. If renal function is impaired, excretion into 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 the concentration: for example, at a drug concentration in the blood serum of less than 100 mg/l, the protein binding of ceftriaxone is 95%, and at a concentration of 300 mg/l it is only 85%. Due to the lower albumin content 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 meninges Ceftriaxone penetrates into the cerebrospinal fluid, and in the case of bacterial meningitis, an average of 17% of the drug concentration in the blood serum diffuses into the cerebrospinal fluid, which is approximately 4 times more than in aseptic meningitis. 24 hours after intravenous administration of ceftriaxone at a dose of 50-100 mg/kg body weight, the concentration in the cerebrospinal fluid exceeds 1.4 mg/l. In adult patients with meningitis, 2-25 hours after administration of ceftriaxone at a dose of 50 mg/kg body weight, the concentration of ceftriaxone many times exceeded the minimum inhibitory dose necessary to suppress the pathogens that most often cause meningitis.

Indications for use:

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

Directions for use and dosage:

For adults and children over 12 years old: Average daily dose is 1-2 g of ceftriaxone once a day (every 24 hours). In severe cases or in cases of infections caused by mild sensitive pathogens, a single daily dose can be increased to 4 g.
For newborns, infants and children under 12 years of age: For a one-time daily dosage, it is recommended next diagram:
For newborns (up to two weeks of age): 20-50 mg/kg body weight per day (the dose of 50 mg/kg body weight is not allowed to be exceeded due to the immature enzyme system of newborns).
For infants and children under 12 years of age: The daily dose is 20-75 mg/kg body weight. In children weighing 50 kg or more, the adult dosage should be followed. Doses 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 proven that there is a 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, caused by Pseudomonas aeruginosa), their joint administration is justified.
Due to the physical incompatibility of ceftriaxone and aminoglycosides, it is necessary to prescribe them separately in recommended doses!
Meningitis:
For bacterial meningitis in newborns and children, the initial dose is 100 mg/kg body weight once a day (maximum 4 g). Once the pathogenic microorganism has been isolated and its sensitivity has been determined, the dose must be reduced accordingly. The best results were achieved with the following periods 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 procedures, to prevent postoperative infections, depending on the risk of infection, a single administration of ceftriaxone in 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 normal function liver, there is no need to reduce the dose of ceftriaxone. Only in case of preterminal renal failure (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 renal function is preserved, there is also no need to reduce the dose of ceftriaxone.
In cases of simultaneous presence of severe liver and kidney pathology, the concentration of ceftriaxone in the blood serum must 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% lidocaine solution 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 administered intravenously slowly over 2-4 minutes.
Intravenous infusion:
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: 0.9% sodium chloride solution, 5% glucose solution, 10% glucose solution, 5% levulose solution.

Side effects:
System 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 liver enzymes, congestion in the gallbladder, oliguria, increased serum creatinine, mycoses in the genital area, chills, anaphylaxis or anaphylactic reactions. Pseudomembranous enterocolitis and blood clotting disorders are extremely rare.
Local side effects:
After intravenous administration, phlebitis was observed in some cases. This phenomenon can be prevented by slow (over 2-4 minutes) administration of the drug. The described side effects usually disappear after stopping therapy.

Contraindications:

Hypersensitivity to cephalosporins and penicillins. First trimester of pregnancy.

Drug interactions:
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 lowered by hemodialysis or peritoneal dialysis. Symptomatic measures are recommended to treat 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, which requires immediate therapy - first, adrenaline is administered intravenously, then glucocorticoids.
Sometimes when ultrasound examination gallbladder, a shadow is noted, indicating sedimentation. This symptom disappears after completion or temporary cessation of ceftriaxone therapy. Even if there is pain syndrome such cases do not require surgical intervention, sufficient is conservative treatment.
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 penetrates into breast milk, you should not continue breastfeeding during treatment with ceftriaxone.
With long-term use, periodic monitoring of the blood count is necessary. Ceftriaxone is used only in hospital settings

Release form
Powder for the preparation of solution for injection, 1.0 g in glass bottles, each bottle is packed in 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 expiration date stated on the package.

Conditions for dispensing from pharmacies
Dispensed with a doctor's prescription.

Manufacturer:

"Vertex Exports", India.

Comments

(visible only to specialists verified by the MEDI RU editorial team)

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 medicine ordering service.

The method of administration is also explained. If we are talking about mild diseases that are treated at home, Ceftriaxone is administered intramuscularly. This can be done either by the mother herself, if she has the necessary skills and desire, or by a nurse who will come to the house.

Intravenous administration is most often practiced in hospitals. This is due to the fact that the patient with such treatment is often in serious condition. Therefore, in addition to injections, he may need other procedures and studies that can only be carried out in a medical institution.

"Ceftriaxone", how to dilute it correctly?

If there is a need for intravenous or intramuscular administration of an antibiotic, then it is important to know how to dilute Ceftriaxone. The medicine itself is available in powder form in bottles of different sizes. In addition to the antibiotic, you will need sterile water for injection and an anesthetic - Novocaine or Lidocaine.

It is important to remember that Ceftriaxone, Novocaine and Lidocaine may cause severe allergic reaction , so be sure to check medications for sensitivity. To do this, make small scratches on the inside of the forearm and apply a small amount of medicine to them, each separately. If no redness occurs after 5-10 minutes, then hypersensitivity is not detected.

Ceftriaxone dilution for intramuscular administration

Take sterile water for injection and a bottle of Ceftriaxone. Then for every 0.5 g of medicine you need 2 ml of solvent, 1 g of antibiotic is dissolved in 3.5 ml. The medicine is injected into the upper outer part (quadrant) of the buttock. To prevent pain from the injection, an additional injection of Novocaine or Lidocaine is given.

The given method of administering Ceftriaxone in children is practically not used due to the fact that two injections need to be given. Therefore, another method is used - they take part of the water for injection, dissolve the powder in it, and then add Lidocaine in the required dose (for example, from 5 ml, 3 ml is allocated for water for injection, 2 ml for anesthetic). Then one injection is given as described above.

​Hmm.. I gave injections to myself, but I would definitely be afraid of the kids. What kind of “non-serious” diseases is covered in the article? I read it three times and didn’t understand anything about what it was about.

​I myself would not risk diluting any antibiotics, somehow for me these are serious drugs that doctors should inject.

After all, nurses do this, for example, so this information is unnecessary for me.

I haven’t heard of this drug either, I hope it won’t come in handy!

I have always been very afraid of an allergic reaction to drugs. Now I will test everyone and myself for sensitivity!

Do you use it often? Or what? I'll definitely take it into account, thank you! :)

Mm, why should we? If we collide, the doctor will definitely tell you what and how

I have never come across this drug, but now I will know how to use it.

I’ve never heard of such a drug, but now that I’ve read the information, I’ll take it into account!

How to dilute Ceftriaxone with Novocaine

Ceftriaxone is a broad-spectrum antibiotic from the group of III generation Cephalosporins. It has a bactericidal effect, that is, it kills pathogenic flora. It is used in the treatment of infections various systems organs:

• in pulmonology in the treatment of bronchopneumonia;
• in general surgery for therapy erysipelas skin;
• in dermatovenerology to combat gonorrhea;
• in urology and nephrology for pyelonephritis.

Ceftriaxone should be diluted with novocaine according to certain rules.

Release form and solutions for diluting the antibiotic

Like most antibiotics, active substance The drug Ceftriaxone is supplied not in the form of a ready-made solution, but in the form of a crystalline powder that is slightly yellowish or white. It comes in bottles clear glass under a rubberized stopper and an aluminum lid. This was done for reasons of preserving the activity of the active substance - ceftriaxone. The powder is easily soluble in water (dissolution time should be no more than 2 minutes according to the standard), very slightly soluble in ethanol. The resulting substance varies in color from light yellow to amber, depending on the shelf life, the type of solvent used and the concentration of the drug.

The drug is dispensed from pharmacies in bottles of 0.25, 0.5, 1 or 2 grams in the form of sterile sodium salt of Ceftriaxone. The most common dosage is 1 g. The instructions for medical use of the drug say that this medicine can be administered exclusively parenterally: intravenously or intramuscularly. Once in the body using one of these methods, the drug is completely absorbed and bioavailability is 100%. The powder can be diluted with water for injection or anesthetics (Lidocaine, Novocaine). These are common liquids for diluting antibiotics. The choice of solution depends on the route of entry of the drug into the body. If a doctor writes a prescription for Ceftriaxone for intramuscular administration, then it is permissible to use any of these solutions. If the medicine must be administered intravenously, the only liquid allowed is water for injection. Lidocaine and Novocaine are strictly prohibited for this purpose.

Features of Ceftriaxone injections

The preparation procedure for the drug is simple. Knowing the precautions and important aspects in the technology of dilution and use of the antibiotic, you can correctly prepare the composition of the required concentration.

The good news is that both Ceftriaxone and the sterile diluent for it can be easily purchased at a regular pharmacy with a doctor's prescription.

Almost all patients note that Ceftriaxone injections are extremely unpleasant and painful, especially when dissolved in water for injection. Moreover, negative sensations will accompany both the process of drug administration and will persist for some time after the manipulation. Therefore, it is much better to dilute the drug with painkillers to make the injection easier to tolerate.

One of the permitted solvents is a 0.5% Novocaine solution. You can also use 1 or 2% lidocaine solution. Doctors still differ on the best basis for the medicine. It should be noted that, according to some scientific data, Novocaine may slightly reduce the severity of the action of Ceftriaxone and increase the risk of developing anaphylactic shock in the patient. But still, it relieves pain during injection quite well in comparison with plain water for injection.

Before administering the full dose of the drug, it is worth doing a tolerance test for Ceftriaxone and the anesthetic used. To do this, you need to make a couple of small scratches on the skin of the inner part of the forearm and apply a few drops of Ceftriaxone and Novocaine separately to them. If a person has high sensitivity to one or both components, the skin at the site of application of the drugs will become very red after 5–10 minutes, swelling and local itching may occur. If everything is fine and there is no allergic reaction to any of the drugs in the solution, then proceed to the procedure.

General rules for the preparation and administration of Ceftriaxone solution for injection

Diluting Ceftriaxone is essentially no different from making solutions of other antibiotics. Standard requirements for preparing a solution for injection are as follows:

• The substance is prepared immediately before use.
• Take the required amount of the drug in powder and a sufficient volume of solvent.
• When performing an injection, the following condition must be observed: more than 1 g of antibiotic should not be injected into one buttock.
• The drug is injected deeply intramuscularly (almost the entire length of the 5 ml syringe needle) into the upper outer quadrant of the buttock.
• Ceftriaxone is infused very slowly during the injection.
• The prepared solution is used exclusively for a single injection; if only part of the contents of the bottle is used for injection, the remainder is always discarded.
• The drug solution remains stable in terms of physical and chemical properties for 6 hours at room temperature, after this time the medicine must be discarded.

The quantitative ratio of Ceftriaxone powder and Novocaine will depend on the concentration of the final solution, according to the recipe.

For intramuscular administration, 0.25, 0.5 or 1 g of antibiotic in the prepared solution can be used. The dosage is determined by the attending physician. In this case, the doctor takes into account the following factors: type and severity of pathology, patient’s age, duration of the disease.

To get 1 g of the finished drug, you need to add 5 ml of 0.5% Novocaine from an ampoule to a bottle with 1 g of Ceftriaxone powder. If you reduce the volume of anesthetic, there is a risk that the antibiotic will not be able to completely dissolve and large particles of the drug will get stuck in the lumen of the needle.

Stages of preparation of novocaine solution of Ceftriaxone

Necessary steps to obtain the solution:

• First you need to prepare everything you need: Ceftriaxone lyophilisate in a glass bottle 1 g or 1000 mg, ampoules with a 0.5% solution of Novocaine (1 ampoule is 5 ml), a 5 ml syringe, sterile balls and gloves, medical alcohol.
• Wash your hands with soap, dry, and put on medical gloves.
• Open the package of the syringe, break off the glass top of the ampoule with Novocaine, bend the aluminum “window” in the central part of the lid of the bottle with the antibiotic.
• Wipe the rubberized stopper of the Ceftriaxone vial with an alcohol-based cotton ball.
• Draw 5 ml of Novocaine into the syringe.
• Pass the needle through the stopper and slowly pour the anesthetic solution into the bottle.
• It is enough to shake the bottle vigorously until the powder disappears completely.
• Draw the required amount of the prepared solution into the syringe.

Thus, a solution with a concentration of Ceftriaxone of 1 g or 1000 mg will be obtained.

• to prepare 0.5 g or 500 mg of the substance, take 0.5 g of powder and 5 ml of Novocaine;
• to obtain 0.25 g or 250 mg, you need 0.5 g of powder and 10 ml of Novocaine, then take half (5 ml) of the resulting solution into a syringe.

Use of medicine in children

For intramuscular use in children, the drug is most often diluted sterile water for injection, since the use of Ceftriaxone with Novocaine can lead to the development of severe anaphylactic reaction. The limited use of analgesics in pediatric patients requires extremely slow and careful administration of the antibiotic to minimize pain during the procedure.

Ceftriaxone dilution table for intramuscular injection

Concentration of Ceftriaxone in the vial, mg

Required dosage of the finished solution, mg

Amount of 0.5% Novocaine, ml

Draw into syringe, ml

In order to combat bacterial infections doctors often prescribe antibacterial drug Ceftriaxone. How to properly dilute it and in what solutions depends on the presence of allergic reactions in a person and on the method of administration. All this is determined by the doctor. It is important to follow his recommendations exactly. If the drug is prescribed as an intramuscular injection, the pain of the injection can be reduced by using an anesthetic, in particular Novocain.

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Antibiotic Ceftriaxone: purpose, use, how to properly dilute at home

If we compare the prescriptions of doctors, the drug Ceftriaxone is the leader among antibiotics for parenteral use. Due to its versatility, it is often prescribed for the treatment of various inflammatory processes outpatient and inpatient settings.

The drug Ceftriaxone is known not only to healthcare workers, but also to ordinary patients who often suffer from respiratory diseases. Ceftriaxone belongs to the group of 3rd generation cephalosporins and is a broad-spectrum antibiotic. Inhibiting transpeptidase stops the biosynthesis of bacterial cell wall mucopeptide.

The effect of the drug applies to many microorganisms: some gram-positive and gram-negative aerobes, anaerobic microorganisms.

Prescription of Ceftriaxone

The active prescription of Ceftriaxone is observed in the lists of the following departments: therapy, surgery, urology, pediatrics and even venereology. When is Ceftriaxone used? The most common diseases for which Ceftriaxone is used:

• Inflammatory processes of ENT organs;
• Frequent diseases of the respiratory system (bronchitis in acute and chronic conditions, tracheitis, pneumonia);
• Infections skin and soft tissues;
• Inflammatory diseases genitourinary system adults and children (acute and chronic cystitis, pyelonephritis, glomerulonephritis, prostatitis, uncomplicated gonorrhea, gynecological diseases);
• Infectious processes of the gastrointestinal tract (peritonitis, postoperative conditions on the digestive organs);
• For osteomyelitis (infectious bone lesions);
• When carrying salmonella and diseases resulting from its activity;
• Treatment of syphilis (soft chancre);
• For infectious neurological diseases(meningitis, Lyme disease);
• To prevent development infectious processes after various surgical interventions.

Why dilute Ceftriaxone?

Since Ceftriaxone is available in powder form, it must be dissolved before administration. The undissolved drug is used only in the form of a powder for bedsores, ulcerative skin lesions and long-term non-healing wounds. Why dilute Ceftriaxone in patients? This only happens in cases of treatment at home. Sometimes sick people refuse medical care and make intramuscular injections on their own with the help of relatives or close people.

To dilute the drug at home, you must first of all have aseptic conditions. You should also stock up on antiseptics and ask your doctor how to dilute Ceftriaxone yourself. Intramuscular administration of antibiotics is a rather painful procedure, so a 1% solution of lidocaine or 50% novocaine is used to dilute them. These drugs significantly reduce the pain of the injection, but sometimes cause complex allergic reactions.

Therefore, before administration, you should test for an allergic reaction to both the antibiotic and the anesthetic. To do this, use insulin syringe administer the minimum dose of the drug diluted with water for injection on the wrist. If after 20 minutes no changes appear at the injection site, the drug can be administered.

Ceftriaxone dilution for intramuscular use

Provided that the patient does not have allergic reactions to the antibiotic or the solvent, the drug can be administered. If lidocaine was chosen to reduce pain, then you should draw 2 ml of a 2% solution into a syringe (usually a whole ampoule) and add 3 ml of water for injection. This is done to thoroughly dilute Ceftriaxone, since lidocaine is a poor solvent and a fairly strong local anesthetic. Using scissors, open the metal cap on the bottle. Alcohol solution treat the rubber stopper before inserting the needle. Shake the bottle thoroughly until completely dissolved. The prepared solution of Ceftriaxone for intramuscular use is drawn back into the syringe.

Dilution table for Ceftriaxone with lidocaine 2% for intramuscular injection

For intramuscular injection Ceftriaxone solution should be used in a syringe with two needles, or 2 syringes. Before carrying out the manipulation, the needle should be replaced with a new one. Once the rubber is pierced, the old one becomes significantly dull and this can cause additional pain and bruising. For children under 1 year of age, Ceftriaxone is diluted only with water for injection or sodium chloride solution.

Ceftriaxone is administered intramuscularly slowly and deeply. The antibiotic can only be injected into the upper outer quadrant (gluteus muscle). Lumps may form at the injection site. To prevent them, you can make an iodine grid.

Dilution of Ceftriaxone for intravenous use

Most often, when diluting Ceftriaxone for intravenous administration, a 0.09 sodium chloride solution is used. If the dosage does not exceed 1g, then the drug is administered slowly in a stream. In other cases, the solution is administered by dropper over 30 minutes using 100 ml of sodium chloride solution.

Ceftriaxone is administered intravenously only in a medical office setting. If the patient insists on treatment at home, then the help of a qualified healthcare professional is required. Ceftriaxone solution for intravenous use should be used immediately after dilution. The drug administered intravenously enters the bloodstream much faster, and accordingly its effectiveness is much higher. In addition, patients experience less unpleasant painful sensations.

Contraindications and individual intolerance to Ceftriaxone

In most cases, Ceftriaxone is tolerated without negative consequences. In some cases, rare reactions occur. Allergic reactions can almost always be avoided because a sensitivity test is performed before starting antibiotic treatment.

1. Hypersensitivity to antibiotics from the cephalosporin group (if the patient has had reactions to the drugs penicillin group, then the likelihood of a cross-allergic reaction to Ceftriaxone increases).
2. Premature children (before prescribing the drug, the pediatrician takes into account the need for such therapy by first calculating the gestational age and age after birth).
3. Increased levels of bilirubin in the blood in premature and newborn babies. This is due to the property of Ceftriaxone to displace the bilirubin molecule from its connection with blood plasma albumin. This condition can provoke the development of encephalopathy.
4. Treatment with Ceftriaxone is prohibited in the first trimester of pregnancy since it is during this period that there is the greatest risk of mutations.
5. Period breastfeeding– since the drug is infiltrated into breast milk. During this period, feeding should be postponed until the end of treatment.
6. Hepatic-renal failure is a contraindication to treatment with Ceftriaxone. If, for medical reasons, the doctor is forced to prescribe this drug, you should monitor the indicators functional state kidneys and liver.

If the patient is on hemodialysis, then the concentration of Ceftriaxone in plasma should be regularly determined. Intolerance to Ceftriaxone may occur due to the characteristics of the body. Most often the cause is genetic characteristics or long-term antibacterial therapy in the anamnesis.

Have you used Ceftriaxone or managed with other drugs?

How to properly dilute the antibiotic Ceftriaxone? What solvents to use (novocaine, lidocaine, water for injection) to reduce pain and what quantity is needed to obtain a dosage of 1000 mg, 500 mg and 250 mg for adults and children

In the article we will talk about diluting the antibiotic Ceftriaxone with a solution of Lidocaine 1% and 2% or water for injection for adults and children to obtain the initial dosage of the finished drug solution of 1000 mg, 500 mg or 250 mg. We will also look at what is better to use for diluting the antibiotic - Lidocaine, Novocaine or Water for injection and what better helps relieve pain during the injection of the prepared Ceftriaxone solution.

These questions are the most common, so now there will be a link to this article so as not to be repeated. Everything will be with examples of use.

In all instructions for Ceftriaxone (including drugs under a different name, but with the same composition), 1% Lidocaine is recommended as a solvent.

1% Lidocaine is already contained as a solvent in packages of such drugs as Rosin, Rocephin and others (the active ingredient is Ceftriaxone).

Advantages of Ceftriaxone with solvent in packaging:

• no need to buy a solvent separately (figure out which one);
• the required dose of solvent is already measured in the ampoule of the solvent, which helps to avoid mistakes when drawing the required amount into the syringe (no need to figure out exactly how much solvent to take);
• in the ampoule with the solvent there is a ready-made solution of 1% lidocaine - there is no need to dilute 2% lidocaine to 1% (it can be difficult to find exactly 1% in pharmacies, you have to dilute it additionally with water for injection).

Disadvantages of Ceftriaxone with a solvent in the package:

• An antibiotic together with a solvent is more expensive (choose what is more important to you - convenience or cost).

How to dilute and inject Ceftriaxone

For intramuscular injection, 500 mg (0.5 g) of the drug should be dissolved in 2 ml (1 ampoule) of a 1% solution of Lidocaine (or for 1000 mg (1 g) of the drug - 3.5 ml of Lidocaine solution (usually 4 ml is used, since this amounts to 2 ampoules of Lidocaine 2 ml each)). It is not recommended to inject more than 1 g of solution into one gluteal muscle.

The dosage of 250 mg (0.25 g) is diluted in the same way as 500 mg (250 mg ampoules did not exist at the time of writing this instruction). That is, 500 mg (0.5 g) of the drug should be dissolved in 2 ml (1 ampoule) of a 1% solution of Lidocaine, and then draw half of the finished solution into two different syringes.

So let's summarize:

1. We obtain 250 mg (0.25 g) of the finished solution as follows:

500 mg (0.5 g) of the drug should be dissolved in 2 ml (1 ampoule) of a 1% solution of Lidocaine and the resulting solution should be drawn into two different syringes (half of the finished solution each).

2. We obtain 500 mg (0.5 g) of the finished solution as follows:

500 mg (0.5 g) of the drug should be dissolved in 2 ml (1 ampoule) of a 1% solution of Lidocaine and draw the resulting solution into 1 syringe.

3. We obtain 1000 mg (1 g) of the finished solution as follows:

1000 mg (1 g) of the drug should be dissolved in 4 ml (2 ampoules) of a 1% solution of Lidocaine and draw the resulting solution into 1 syringe.

How to dilute Ceftriaxone with 2% lidocaine solution

Below is a plate with dilution schemes for the antibiotic Ceftriaxone with a 2% solution of Lidocaine (a 2% solution is found in pharmacies more often than a 1% solution; the dilution method we have already discussed above):

Abbreviations in the table: CEF - Ceftriaxone, R-l - solvent, V injection - water for injection. Below are examples and explanations.

The child was prescribed a course of Ceftriaxone injections twice a day, 500 mg (0.5 g) for 5 days. How many vials of ceftriaxone, ampoules with solvent and syringes will be needed for the entire course of treatment?

If you bought Ceftriaxone 500 mg (0.5 g) (the most convenient option) and Lidocaine 2% at the pharmacy, you will need:

• 10 vials of ceftriaxone;
• 10 ampoules of lidocaine 2%;
• 10 ampoules of water for injection;
• 20 syringes, 2 ml each (2 syringes for each injection - add the solvent with one, draw and inject with the second).

If you bought Ceftriaxone 1000 mg (1.0 g) at the pharmacy (you didn’t find Ceftriaxone 0.5 g) and Lidocaine 2%, you will need:

• 5 vials of Ceftriaxone;
• 5 ampoules Lidocaine 2%
• 5 ampoules of water for injection
• 5 syringes of 5 ml and 10 syringes of 2 ml (3 syringes to prepare 2 injections - add the solvent with one, draw the required volume with the second and third, inject the second immediately, put the third in the refrigerator and inject after 12 hours).

The method is acceptable provided that the solution is prepared for 2 injections at once and the syringe with the solution is stored in the refrigerator (freshly prepared ceftriaxone solutions are physically and chemically stable for 6 hours at room temperature and for 24 hours when stored in the refrigerator at a temperature of 2° to 8°C ).

Disadvantages of this method: injection of an antibiotic after storage in the refrigerator may be more painful; during storage, the solution may change color, which indicates its instability.

The same dosage of Ceftriaxone 1000 mg and Lidocaine 2%, although the regimen is more expensive, but less painful and safer:

• 10 vials of ceftriaxone;
• 10 ampoules of lidocaine 2%;
• 10 ampoules of water for injection;
• 10 syringes of 5 ml and 10 syringes of 2 ml (2 syringes for each injection - one (5 ml) we add the solvent, the second (2 ml) we draw and inject). Half of the resulting solution is drawn into the syringe, the rest is thrown away.

Disadvantage: treatment is more expensive, but freshly prepared solutions are more effective and less painful.

Now popular questions and answers to them.

Why use Lidocaine, Novocaine for diluting Ceftriaxone and why can’t you use water for injection?

To dilute Ceftriaxone to the required concentrations, you can also use water for injection, there are no restrictions, but you need to understand that intramuscular injections of the antibiotic are very painful and if this is done in water (this is what they usually do in hospitals), then it will hurt as much as when injected drug, and for some time after. So it is preferable to use an anesthetic solution as a means for dilution, and use water for injection only as an auxiliary solution when diluting Lidocaine 2%.

There is also a point that it is not possible to use Lidocaine and Novocaine due to the development of allergic reactions to these solutions. Then the option of using water for injection for dilution remains the only possible one. Here you will have to endure pain, since there is a real chance of dying from anaphylactic shock, Quincke's edema, or getting a severe allergic reaction (the same urticaria).

Also, Lidocaine cannot be used for intravenous administration of an antibiotic, only STRICTLY intramuscularly. For intravenous use it is necessary to dilute the antibiotic in water for injection.

What is better to use Novocaine or Lidocaine to dilute the antibiotic?

Novocaine should not be used to dilute Ceftriaxone. This is due to the fact that Novocain reduces the activity of the antibiotic and, in addition, increases the risk of the patient developing fatal dangerous complication- anaphylactic shock.

In addition, according to the observations of the patients themselves, the following can be noted:

• pain during the administration of Ceftriaxone is better relieved by Lidocaine than Novocaine;
• pain during administration may intensify after the administration of not freshly prepared solutions of Ceftriaxone with Novocaine (according to the instructions for the drug, the prepared solution of Ceftriaxone is stable for 6 hours - some patients practice preparing several doses of the Ceftriaxone + Novocaine solution at once to save antibiotic and solvent (for example, solutions of 250 mg of Ceftriaxone from powder 500 mg), otherwise the remainder would have to be thrown away, and for the next injection use a solution or powder from new ampoules).

Is it possible to mix different antibiotics in one syringe, including Ceftriaxone?

Under no circumstances should ceftriaxone solution be mixed with solutions of other antibiotics, because it may crystallize or increase the patient's risk of developing allergic reactions.

How to reduce pain when administering Ceftriaxone?

It is logical from the above - you need to dilute the drug with Lidocaine. In addition, the skill of administering the finished drug also plays an important role (you need to administer it slowly, then painful sensations will be small).

Can I prescribe an antibiotic myself without consulting a doctor?

If you are guided by the main principle of medicine - Do no harm, then the answer is obvious - NO!

Antibiotics are medications that cannot be dosed or prescribed yourself, without consulting a specialist. Since choosing an antibiotic based on the advice of friends or on the Internet, we thereby narrow the field of activity for doctors who can treat the consequences or complications of your disease. That is, the antibiotic did not work (it was injected or diluted incorrectly, it was taken incorrectly), but it was good, and since the bacteria were already accustomed to it, as a result wrong scheme treatment, then you will have to prescribe a more expensive backup antibiotic, which, after incorrect previous treatment, is also unknown whether it will help. So the situation is clear - you need to go to the doctor for a prescription and prescription.

Also, allergy sufferers (ideally, again, all patients who are taking this drug for the first time) are also advised to prescribe scratch tests to determine an allergic reaction to prescribed antibiotics.

Also, ideally, seeding is necessary biological fluids and human tissues with determination of the sensitivity of cultured bacteria to antibiotics, so that the prescription of a particular drug is justified.

I would like to believe that after the appearance of this article in the Directory, there will be fewer questions on the methods and dilution schemes for the antibiotic Ceftriaxone, since I have analyzed the main points and schemes here, all that remains is to read carefully.

Lidocaine can be taken in 1% and 2% solutions. If it is 2%, then it still needs to be diluted with water for injection 1:1, and then the antibiotic should be diluted with the resulting solution.

Lidocaine! it is forbidden! administer intravenously, only strictly intramuscularly

Water for injection should be diluted if there is an allergy to lidocaine, or intravenous antibiotic injections are indicated.

dissolve 5oo mg of ceftriaxone in 2 ml (one ampoule) of 1% lidocaine solution. If the dosage of the antibiotic is higher, then, accordingly, 1 g of ceftriaxone per 4 ml (2 ampoules) of lidocaine.

If suddenly the pharmacy does not have 1% lidocaine, you can use 2% plus water for injection. Those. 5oo mg of ceftriaxone - per 1 ml of 2% lidocaine solution and 1 ml of water for injection

* Do not use novocaine! Despite the fact that it is also an excellent pain reliever, in combination with an antibiotic it can cause a severe allergic reaction.

* It is advisable, of course, to test for lidocaine before preparing the solution

* Ceftriaxone solution with lidocaine can only be used intramuscularly!

* The diluted antibiotic should be administered slowly for better absorption and less painful consequences of the injection

* The diluted drug should not be stored for more than 6 hours

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• distilled water;
• sodium chloride;
• Lidocaine;
• Novocaine.

Correct dosages

• abdominal pain;
• frequent diarrhea;
• nausea and vomiting.

Instructions for use of Ceftriaxone, how to dilute for injections

Purpose and features of use of the drug

The instructions for use of this medicine say: when the antibiotic is administered intramuscularly, there is quite severe painful discomfort. For decreasing discomfort medicinal substance It is recommended to dilute with an anesthetic.

Ceftriaxone is a white crystalline powder that is sometimes yellowish in color.

As practice shows, thanks to injections, positive changes in the patient’s condition are noted already on the second or third day.

It is important to remember that each patient will react differently to the antibiotic and the means in which it should be dissolved. Injections should be given only after special test, which will show whether the prepared solution is suitable for the patient or not.

What is best for diluting the drug?

It is necessary to consider in more detail the question of what means and why doctors recommend diluting the antibiotic.

As already mentioned, you can dissolve the medicinal substance:

• distilled water;
• sodium chloride;
• Lidocaine;
• Novocaine.

Before injecting Ceftriaxone, it is better to ask a specialist which solvent is the best for treatment. Don't forget about the many nuances that may arise.

For example, if an antibiotic is prescribed for intramuscular (IM) administration to a child, dilution of the anesthetic with water or sodium chloride is indicated. The ratio of the drug and distilled liquid or saline solution is 1:1.

Water for injection will be the only option for those patients who have an allergic reaction to anesthetics.

Correct dosages

How to dilute Ceftriaxone before the upcoming injection? In some patients, administration of an antibiotic that is dissolved in lidocaine may cause an unwanted immune response.

The attached instructions for use of the antibiotic recommend dissolving Ceftriaxone with 1% Lidocaine.

There should be no problems when diluting the powdered substance, since it dissolves quite easily. Doctors warn: if you dilute the medicine and cloudiness or any foreign impurities appear, you should refrain from using the solution.

Unfortunately, it is not always possible to obtain 1% Lidocaine. Usually 2% anesthetic is sold in pharmacies. In this case, to achieve best effect, it should be diluted with a small amount of water.

As stated in the instructions, if you need to dilute Ceftriaxone in an amount of 0.5 g, you need to prepare 1 ml of Lidocaine and water.

Adult patients are allowed to use no more than two grams of the diluted substance per day, while a maximum of 1 g of medication can be injected into one buttock.

The diluted mixture should be used immediately. If you administer solutions immediately after preparation, you can get the desired results much faster.

Dosages for children, during pregnancy and lactation

Is it possible to use Ceftriaxone in childhood and how to do it correctly? Ceftriaxone intramuscularly can be prescribed from birth.

If you need to use a diluted drug in a dose that is greater than the established norm, a dropper is used instead of an injection. Children from 12 years of age are prescribed the same dosages as adults.

Despite the accepted standards of medication, when drawing up a treatment course, the dosage is selected on an individual basis. The specialist must take into account clinical manifestations illness, its severity and characteristics of the child’s body.

Contraindications and possible complications

Ignoring them and non-compliance with dosages, especially with intravenous injections, can cause dangerous consequences both in adults and children.

If the patient does not adhere to the prescribed dosage or begins to use a solution that has been stored longer than prescribed, the occurrence of dysbacteriosis cannot be ruled out. The drug has the property of suppressing the activity of microbes. If the medicine is used incorrectly, beneficial microorganisms die along with pathogenic microorganisms.

A violation is indicated by symptoms such as:

• abdominal pain;
• frequent diarrhea;
• nausea and vomiting.

Due to dysbacteriosis, the development of a fungal infection is possible.

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