The medicine contains ceftriaxone - an antibiotic from the class of cephalosporins (β-lactam antibiotics, the chemical structure of which is based on 7-ACC).
The substance is a slightly hygroscopic, finely crystalline powder of yellowish or white. One bottle of the drug contains 0.25, 0.5, 1 or 2 grams of sterile sodium salt ceftriaxone.
Release form
Powder 0.25/0.5/1/2 g for preparation:
- d/i solution;
- solution for infusion therapy.
Ceftriaxone is not available in tablets or syrup.
pharmachologic effect
Bactericidal. A third generation drug from the group of antibiotics “Cephalosporins”.
Pharmacodynamics and pharmacokinetics
Pharmacodynamics
A universal antibacterial agent, the mechanism of action of which is determined by the ability to suppress the synthesis of the bacterial cell wall. The drug exhibits greater resistance to most β-lactamases of Gram (+) and Gram (-) microorganisms.
Active regarding:
- Gram (+) aerobes - St. aureus Epidermidis, Streptococcus (pneumoniae, pyogenes, groups viridans);
- Gram (-) aerobes - Enterobacter aerogenes And cloacae, Acinetobacter calcoaceticus, Haemophilus influenzae(including in relation to penicillinase-producing strains) and parainfluenzae, Borrelia burgdorferi, Klebsiella spp.(including pneumoniae), Escherichia coli, Moraxella catarrhalis and diplococci 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 observed against strains of the following bacteria: Citrobacter diversus And freundii, Salmonella spp.(including in relation to Salmonella typhi), Providencia spp.(including in relation to Providencia rettgeri), Shigella spp.; Bacteroides bivius, Streptococcus agalactiae, Bacteroides melaninogenicus.
Resistant to methicillin Staphylococcus, many strains Enterococcus(including Str. faecalis) And Streptococcus group D to (including ceftriaxone) are resistant.
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 in bacterial cell walls.
Pharmacokinetics
- bioavailability - 100%;
- T Cmax when Ceftriaxone is administered intravenously - at the end of the infusion, when administered intramuscularly - 2-3 hours;
- connection with plasma proteins - from 83 to 96%;
- T1/2 with intramuscular administration - 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 cerebrospinal fluid when administered 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 excreted unchanged:
- kidneys - by 33-67% (in newborn babies this figure is 70%);
- with bile into the intestines (where the drug is inactivated) - by 40-50%.
Hemodialysis is ineffective.
Indications for use of Ceftriaxone
The annotation states that the indications for the use of Ceftriaxone are infections caused by bacteria sensitive to the drug. Intravenous infusions and injections of medications are prescribed to treat:
- infections abdominal cavity(including when empyema of the gallbladder , angiocholitis , peritonitis ), ENT organs and respiratory tract (pleural empyema , pneumonia , , lung abscess etc.), bone and joint tissue, soft tissues and skin, urogenital tract (including , pyelitis , , , epididymitis );
- epiglottitis ;
- infected burns/wounds;
- infectious lesions of the maxillofacial area;
- bacterial septicemia ;
- sepsis ;
- bacterial ;
- bacterial meningitis ;
- chancroid ;
- tick-borne borreliosis (Lyme disease);
- uncomplicated gonorrhea (including in cases where the disease is caused by microorganisms that secrete penicillinase);
- salmonellosis/salmonella carriage ;
- typhoid fever .
The drug is also used for perioperative prophylaxis and for the treatment of patients with weakened .
What is Ceftriaxone used for for syphilis?
Despite the fact that when various forms syphilis the drug of choice is , its effectiveness may be limited in some cases.
For use cephalosporin antibiotics resorted to as a backup option in case of drug intolerance penicillin group .
The valuable properties of the drug are:
- presence in its composition chemical substances, which have the ability to suppress the formation cell membranes and mucopeptide synthesis in bacterial cell walls;
- the ability to quickly penetrate organs, fluids and tissues of the body and, in particular, , which in patients with syphilis undergoes many specific changes;
- Possibility of use for the treatment of pregnant women.
The medicine is most effective in cases where the causative agent of the disease is Treponema pallidum, because the distinctive feature Ceftriaxone has high treponemocidal activity. The positive effect is especially pronounced with intramuscular administration of the drug.
Treatment syphilis with the use of the drug gives good results not only on early stages development of the disease, but also in advanced cases: with neurosyphilis , as well as with secondary and hidden syphilis .
Since T1/2 of Ceftriaxone is approximately 8 hours, the drug can be used equally successfully in both inpatient and outpatient treatment regimens. It is enough to administer the drug to the patient once a day.
For preventive treatment, the drug is administered for 5 days, for primary syphilis — 10-day course, early hidden and secondary syphilis are treated within 3 weeks.
When forms are not running neurosyphilis the patient is administered a single dose of 1-2 g of Ceftriaxone for 20 days; in the later stages of the disease, the medicine is administered at a dose of 1 g/day. for 3 weeks, after which an interval of 14 days is maintained and treatment with a similar dosage is carried out for 10 days.
In 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?
Although antibiotic effective for various lesions nasopharynx (including when and at ), it is generally 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 regular injections into the muscle. However, in the vast majority of cases, the patient is prescribed intramuscular injections. The solution is prepared immediately before use. The finished mixture remains stable at room temperature for 6 hours after preparation.
Children at sore throat Ceftriaxone is prescribed in exceptional cases when acute sore throat 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 medicine crosses the placental barrier, it does not have a significant effect on the health and development of the fetus.
Treatment of sinusitis with Ceftriaxone
At sinusitis antibacterial agents are first-line drugs. Completely penetrating the blood, Ceftriaxone is retained at the site of inflammation in the required concentrations.
As a rule, the medicine is prescribed in combination with mucolytics , vasoconstrictors etc.
How to inject the drug when sinusitis ? Typically, the patient is prescribed Ceftriaxone to be injected into the muscle twice a day, 0.5-1 g. Before injection, the powder is mixed with (it is preferable to use a one percent solution) or d/i water.
Treatment lasts at least 1 week.
Contraindications
Ceftriaxone is not prescribed in cases of known hypersensitivity to cephalosporin antibiotics or auxiliary components of the drug.
Relative contraindications:
- neonatal period if the child has hyperbilirubinemia ;
- prematurity ;
- / liver failure ;
- enteritis , UC or , associated with the use antibacterial agents ;
- pregnancy;
- lactation.
Side effects of Ceftriaxone
Side effects of the drug appear as:
- hypersensitivity reactions - eosinophilia , fever, skin itching, , edema, skin rash, multiform (in some cases malignant) exudative erythema ,serum sickness , , chills;
- headache and dizziness;
- oliguria ;
- dysfunction of the digestive system (nausea, vomiting, , taste disturbance, , sludge formation in gallbladder And pseudocholelithiasis , pseudomembranous enterocolitis , , candidomycosis and other superinfections);
- hematopoiesis disorders (including hemolytic ;lympho-, leuko-, neutro-, thrombocytopenia, granulocytopenia ; thrombo- And leukocytosis ,hematuria , basophilia , nosebleeds).
If the medicine is administered intravenously, inflammation of the venous wall, as well as pain along the vein, is possible. The injection of the drug into the muscle is accompanied by pain at the injection site.
Ceftriaxone (injections and IV infusion) may also affect laboratory parameters. The patient's prothrombin time decreases (or increases), the activity of alkaline phosphatase and liver transaminases increases, as well as the concentration of urea, develops hypercreatininemia , hyperbilirubinemia , glucosuria .
Reviews of the side effects of Ceftriaxone allow us to conclude that with intramuscular administration of the drug, almost 100% of patients complain of severe pain from the injection, some report muscle pain, dizziness, chills, weakness, itching and rash.
The injections are easiest to tolerate if you dilute the powder with an anesthetic. In this case, it is necessary to do a test both for the drug itself and for the painkiller.
Instructions for use of Ceftriaxone. How to dilute Ceftriaxone for injection?
The manufacturer's instructions, as well as the Vidal reference book, indicate that the drug can be injected into a vein or into a muscle.
Dosage for adults and children over 12 years of age: 1-2 g/day. The antibiotic is administered once or once every 12 hours at half the dose.
In particularly serious cases, as well as if the infection is caused by a pathogen moderately sensitive to Ceftriaxone, the dose is increased to 4 g/day.
Based on the reviews of the patients themselves, they note that Lidocaine better than Novocaine , relieves pain when Ceftriaxone is administered.
In addition, the use of a non-freshly prepared solution of Ceftriaxone with Novocaine , contributes to increased pain during injection (the solution remains stable for 6 hours after preparation).
How to dilute Ceftriaxone with Novocaine?
If it is still used as a solvent Novocaine , it is taken in a volume of 5 ml per 1 g of the drug. If you take a smaller amount Novocaine , the powder may not completely dissolve, and the syringe needle will become clogged with lumps of medicine.
Dilution with Lidocaine 1%
For injection into the muscle, 0.5 g of the drug is dissolved in 2 ml of a one percent solution Lidocaine (contents of one ampoule); For 1 g of the drug take 3.6 ml of solvent.
The dosage of 0.25 g is diluted in the same way as 0.5 g, that is, with the contents of 1 ampoule of 1% Lidocaine . After this, the finished solution is drawn into different syringes, half the volume in each.
The medicine is injected deep into the gluteal muscle (no more than 1 g in each buttock).
Diluted Lidocaine the drug is not intended for intravenous administration. It is allowed to be injected strictly into the muscle.
How to dilute Ceftriaxone injections with Lidocaine 2%?
To dilute 1 g of the drug, take 1.8 ml of water and two percent Lidocaine . To dilute 0.5 g of the drug, also mix 1.8 ml Lidocaine with 1.8 ml of water d/i, but only half of the resulting solution (1.8 ml) is used for dissolution. To dilute 0.25 g of the drug, take 0.9 ml of a solvent prepared in a similar way.
How to dilute Ceftriaxone for intramuscular administration in children?
The given method of intramuscular injections is practically not used in pediatric practice, since Ceftriaxone with novocaine can cause severe anaphylactic shock , and in combination with lidocaine - may contribute to the occurrence seizures and cardiac dysfunction.
For this reason, the optimal solvent when using the drug in children is plain water di. Inability to use painkillers childhood requires even slower and more careful administration of the drug to reduce painful sensations during the injection.
Dilution for intravenous administration
For intravenous administration, 1 g of the drug is dissolved in 10 ml of distilled water (sterile). The drug is administered slowly over 2-4 minutes.
Dilution for intravenous infusion
When carrying out infusion therapy, the drug is administered for at least half an hour. To prepare a solution, 2 g of powder is diluted in 40 ml of Ca-free solution: dextrose (5 or 10%), NaCl (0,9%), fructose (5%).
Additionally
Ceftriaxone is intended exclusively for parenteral administration: manufacturers do not produce tablets and suspensions due to the fact that antibiotic in contact with body tissues, it exhibits high activity and greatly irritates them.
Doses for animals
The dosage for cats and dogs is selected taking into account the body weight of the animal. As a rule, it is 30-50 mg/kg.
If a 0.5 g bottle is used, add 1 ml of two percent Lidocaine and 1 ml water d/i (or 2 ml Lidocaine 1%). After vigorously shaking the medicine until the lumps are completely dissolved, it is drawn into a syringe and injected into the muscle or under the skin of the sick animal.
The dosage for a cat (Ceftriaxone 0.5 g is usually used for small animals - cats, kittens, etc.), if the doctor prescribed 40 mg of Ceftriaxone per 1 kg of weight, is 0.16 ml/kg.
For dogs (and other large animals), take bottles of 1 g. The solvent is taken in a volume of 4 ml (2 ml Lidocaine 2% + 2 ml water d/i). For a dog weighing 10 kg, if the dose is 40 mg/kg, you need to administer 1.6 ml of the prepared solution.
If it is necessary to administer Ceftriaxone intravenously through a catheter, sterile distilled water is used for dilution.
Overdose
Signs of a drug overdose are convulsions and central nervous system stimulation. Peritoneal dialysis And hemodialysis are ineffective in reducing ceftriaxone concentrations. The medicine does not have an antidote.
Therapy: symptomatic.
Interaction
In one volume it is pharmaceutically incompatible with others antimicrobial agents .
By suppressing intestinal microflora, it prevents the formation of vitamin K . For this reason, the use of the drug in combination with drugs that reduce platelet aggregation (sulfinpyrazone, NSAIDs) may provoke bleeding.
The same feature of Ceftriaxone enhances the effect of anticoagulants when used together.
In combination with loop diuretics the risk of developing nephrotoxicity .
Terms of sale
A prescription is required to purchase.
In Latin it might be as follows. Recipe in Latin (sample):
Rp.: Ceftriaxoni 0.5
D.t.d.N.10
S. In the supplied solvent. V/m, 1 rub./day.
Storage conditions
Keep away from light. The optimal storage temperature is up to 25°C.
When used without medical supervision, the drug can cause complications, so bottles with powder should be kept out of the reach of children.
Best before date
special instructions
The drug is used in a hospital setting. In patients who are on hemodialysis , as well as with simultaneous severe hepatic And renal failure , plasma concentrations of Ceftriaxone should be kept under control.
At long-term treatment Regular monitoring of the peripheral blood picture and indicators characterizing the function of the kidneys and liver is required.
Sometimes (rarely) an ultrasound of the gallbladder may show shadows that indicate the presence of sediment. The darkening disappears after stopping the course of treatment.
In some cases, it is advisable to prescribe to weakened sick and elderly patients in addition to Ceftriaxone vitamin K .
If the balance of water and electrolytes is disturbed, as well as arterial hypertension Plasma sodium levels should be monitored. If the treatment is long-term, the patient is advised to undergo general analysis blood.
, , Cefpotec , Spectraceph .Ceftriaxone or Cefazolin - which is better?
Both drugs belong to the group "Cephalosporins" , but Ceftriaxone is antibiotic III generation, and is a first generation drug.
Important feature cephalosporin antibiotics I generation is that they are not effective against listeria And enterococci , have a narrow spectrum of action and low level activity against Gram (-) bacteria.
Cefazolin used mainly in surgery for perioperative prophylaxis, as well as for the treatment of infections of soft tissues and skin.
Prescribed for the treatment of infections genitourinary system and respiratory tract cannot be considered as justified, which is associated with a narrow spectrum of antimicrobial activity and high resistance to it among potential pathogens.
Which is better: Ceftriaxone or Cefotaxime?
And Ceftriaxone are basic antimicrobial agents of the cephalosporin group III generation. The drugs are almost identical in their bactericidal properties.
Alcohol compatibility
You should not drink alcohol during treatment with the drug. Combination "Ceftriaxone + ethanol" can provoke symptoms similar to those of severe poisoning, and in some cases lead to the death of the patient.
Ceftriaxone during pregnancy and breastfeeding
The drug is contraindicated in the first trimester of pregnancy. If it is necessary to prescribe to a nursing woman, the child should be switched to formula.
INN: Ceftriaxone
Manufacturer: Sandoz GmbH
Anatomical-therapeutic-chemical classification: Ceftriaxone
Registration number in the Republic of Kazakhstan: No. RK-LS-5 No. 021617
Registration period: 15.09.2015 - 15.09.2020
ED (Included in the List of drugs within the framework of the guaranteed volume of free medical care, subject to purchase from the Single Distributor)
Instructions
Tradename
Ceftriaxone Sandoz®
International nonproprietary name
Ceftriaxone
Dosage form
Powder for solution for injection 500 mg, 1000 mg, 2000 mg
Compound
1 bottle contains:
active substance - ceftriaxone sodium 596.7 mg (equivalent to ceftriaxone 500.0 mg) or ceftriaxone sodium 1193.3 mg (equivalent to ceftriaxone 1000.0 mg) or ceftriaxone sodium 2386.6 mg (equivalent to ceftriaxone 2000.0 mg).
Description
Powder from white to yellowish color.
Prepared solution: clear solution from light yellow to brownish-yellow.
Pharmacotherapeutic group
Antibacterial drugs for systemic use.
Beta-lactam antibacterial drugs others.
Third generation cephalosporins. Ceftriaxone.
ATX code J01DD04
Pharmacological properties
Pharmacokinetics
Suction
Following an intravenous bolus injection of Ceftriaxone Sandoz 500 mg and 1000 mg, mean peak plasma concentrations of ceftriaxone are approximately 120 mg/L and 200 mg/L, respectively. Following intravenous infusion of Ceftriaxone Sandoz 500 mg, 1000 mg, and 2000 mg, plasma ceftriaxone levels are approximately 80, 150, and 250 mg/L, respectively. After intramuscular injection, mean peak plasma levels of ceftriaxone are approximately half the concentrations observed after intravenous administration of an equivalent dose. The maximum plasma concentration after a single intramuscular injection of Ceftriaxone Sandoz 1000 mg is about 81 mg/l and is achieved within 2-3 hours after administration. The areas under the plasma concentration-time curve after intravenous and intramuscular administration are the same. This means that the bioavailability of ceftriaxone after intramuscular administration is 100%.
Distribution
The volume of distribution of ceftriaxone is 7-12 liters. Concentrations that were significantly higher than those of major infectious agents could be measured in tissues, including the lungs, heart, biliary tract, liver, tonsils, middle ear and nasal mucosa, bones, and cerebrospinal, pleural, and synovial fluids and secretions. prostate gland. After repeated administration of the drug, there is an increase in the average peak plasma concentration of the drug (Cmax) by 8 - 15%; in most cases and depending on the method of administration, a stable state is achieved within 48-72 hours.
Penetration into individual tissues
Ceftriaxone penetrates into the meninges. The greatest penetration of ceftriaxone occurs through the inflamed meninges. Mean peak concentrations of ceftriaxone in cerebrospinal fluid in patients with bacterial meningitis that have been reported to be up to 25% of plasma levels compared with 2% of plasma levels in patients without inflammation meninges. Peak concentrations of ceftriaxone in the cerebrospinal fluid are achieved approximately 4-6 hours after intravenous injection. Ceftriaxone penetrates through
placental barrier and is excreted with breast milk in low concentrations.
Protein binding
Ceftriaxone binds reversibly to albumin, and the degree of binding decreases with increasing concentration, decreasing, for example, from 95% at a plasma concentration of less than 100 mg/l to 85% at a concentration of 300 mg/l. Due to the lower concentration of albumin in tissue fluid, the proportion of free ceftriaxone in it is higher than in plasma.
Biotransformation
Ceftriaxone does not undergo systemic metabolism, but is converted to inactive metabolites under the influence of intestinal flora.
Removal
The total plasma clearance of ceftriaxone is 10-22 ml/min. Renal clearance is 5-12 ml/min. 50-60% of ceftriaxone is excreted unchanged in the urine, and 40-50% is excreted unchanged in the bile. The half-life of ceftriaxone is approximately 8 hours in adults.
Patients with impaired renal or liver function
In patients with impaired renal or hepatic function the pharmacokinetics of ceftriaxone changes slightly, there is only a slight increase in the half-life (less than 2 times); this even applies to patients with severe renal impairment.
Elderly patients
In persons over 75 years of age, the half-life is, on average, two to three times longer than in younger adults.
Children
In newborns, the half-life of ceftriaxone increases. U
children in the first 14 days of life, free concentrations of ceftriaxone may additionally cause an increase in factors such as a decrease glomerular filtration and cause changes in protein binding. The half-life in children over 4 weeks of age is less than in neonates or adults.
Plasma clearance and total volume of distribution of ceftriaxone in children is higher than in adults.
Linearity/nonlinearity
The pharmacokinetics of ceftriaxone is nonlinear. All major pharmacokinetic parameters based on total drug concentrations, with the exception of half-life, are dose dependent. Nonlinearity depends on the degree of binding to plasma proteins, but this is not
refers to the total plasma concentration of Ceftriaxone Sandoz (unbound).
Pharmacodynamics
Mechanism of action
Ceftriaxone has bactericidal activity due to the inhibition of the synthesis of microbial cell walls (PBPs). This leads to interruption of cell wall (peptidoglycan) biosynthesis, lysis of microorganism cells and their further death.
Resistance
Resistance of microorganisms to ceftriaxone is based on several mechanisms. This mechanism depends on the type: gram-positive, gram-negative, etc.
|
Sensitive microorganisms |
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Gram-positive aerobes: Staphylococcus aureus(methicillin-sensitive)1, Staphylococci coagulase-negative (methicillin-sensitive)1, Streptococcus pyogenes(group A), |
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Streptococcus agalactiae(group B), Streptococcus pneumonia, viridans group, Streptococci Gram-negative aerobes: Borrelia burgdorferi, Haemophilus influenza, Haemophilus parainfluenzae, Moraxella catarrhalis,Neisseria gonorrhea, Neisseria meningitidis, Proteus mirabilis, Providencia spp., Treponema pallidum |
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Insensitive microorganisms |
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Gram-positive aerobes: Staphylococcus epidermidis2 , Staphylococcus haemolyticus2 , Staphylococcus hominis 2 Gram-negative aerobes: Citrobacter freundii, Enterobacter aerogenes , Enterobacter cloacae, Escherichia coli3 , Klebsiella pneumoniae3 , Klebsiella oxytoca3 , Morganella morganii, Proteus vulgaris , Serratia marcescens |
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Anaerobes: Bacteroides spp. , Fusobacterium spp., Peptostreptococcus spp., Clostridium perfringens |
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Resistant microorganisms |
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Gram-positive aerobes: Enterococcus spp., Listeria monocytogenes |
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Gram-negative aerobes: Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia Anaerobes: Clostridium difficile Other: Chlamydia spp., Chlamydophila spp., Mycoplasma spp., Legionella spp., Ureaplasma urealyticum |
1 All methicillin-resistant staphylococci are resistant to ceftriaxone.
2 In at least one area the speed resistance is >50%.
3 ESBL-producing strains are always resistant.
Indications for use
Treatment infectious diseases caused by microorganisms sensitive to ceftriaxone and requiring parenteral antibiotic therapy:
Meningitis
Disseminated Lyme borreliosis (early and late stages diseases)
Infections of the abdominal organs (peritonitis, infections biliary tract and gastrointestinal tract)
Infections of bones, joints, soft tissues, skin, and wound infections
Infections in immunocompromised patients
Kidney and urinary tract infections
Respiratory tract infections, especially pneumonia and ENT infections
Genital infections, including gonorrhea
Preoperative prevention of infections, prevention of secondary infections.
Directions for use and doses
Mode of application
The dose of Ceftriaxone Sandoz is determined individually depending on the severity of the disease, location, type of microorganism and its sensitivity to ceftriaxone, as well as the patient’s age, kidney and liver function.
Adults and children over 12 years of age: a drug 1000 mg -2000 mg are administered intramuscularly once a day(every 24 hours).
In severe cases or for infections whose pathogens are only moderately sensitive to ceftriaxone, the daily dose can be increased to 4 g.
Duration of treatment depends on the course of the disease. As always with antibiotic therapy, the administration of Ceftriaxone Sandoz should be continued in patients for at least 48-72 hours after the temperature has normalized and eradication of the pathogen has been confirmed.
Combination therapy
Synergism has been shown between the drug Ceftriaxone Sandoz and aminoglycosides against many gram-negative bacteria. Although the increased effectiveness of such combinations is not always predictable, it should be kept in mind in severe, life-threatening infections such as due to Pseudomonas aeruginosa. Due to the physical incompatibility of ceftriaxone and aminoglycosides, they should be administered separately at their recommended doses.
In patients with liver dysfunction There is no need to reduce the dose provided there is no impairment of renal function.
In patients with renal dysfunction There is no need to reduce the dose provided there are no liver dysfunctions. The daily dose of Ceftriaxone Sandoz should not exceed 2 g only in cases of renal failure with creatinine clearance less than 10 ml/min.
At combination of severe renal and liver failure The plasma concentration of ceftriaxone should be regularly determined and its dose adjusted if necessary.
Patients on dialysis, additional administration of the drug after dialysis is not required. However, serum ceftriaxone concentrations should be monitored for possible dose adjustments as the elimination rate may be reduced in these patients.
Use in adults and adolescents over 12 years of age (body weight over 50 kg) with special dosage recommendations:
Acute otitis media
The drug 1000 - 2000 mg is administered intramuscularly once a day (every 24 hours). A daily dose of 1000 - 2000 mg should be administered intramuscularly for 3 days.
Preoperative infection prevention
The drug is administered at a dose of 2000 mg intramuscularly once before surgery.
Gonorrhea
The drug, 500 mg, is administered intramuscularly once.
Disseminated Lyme borreliosis (early and late stages of the disease [II + III])
The drug, 2000 mg, is administered intramuscularly once a day for 14 to 21 days.
Newborns, infants and children under 12 years of age
When prescribing Ceftriaxone Sandoz once a day
newborns (up to 14 days) - 20-50 mg/kg body weight once a day. The daily dose should not exceed 50 mg/kg body weight. When determining the dose, there is no need to distinguish between full-term and premature infants.
Ceftriaxone is contraindicated in neonates (≤8 days) who are already receiving or are expected to receive intravenous calcium-containing solutions, including continuous calcium-containing infusions such as parenteral nutrition, due to the risk of precipitates of ceftriaxone calcium salts. Newborns, infants and children younger age(from 15 days to 12 years): 20-80 mg/kg body weight once a day.
Children weighing more than 50 kg are prescribed adult doses.
Meningitis
At bacterial meningitis in infants and young children treatment begins with a dose of 100 mg/kg (but not more than 4 g) once a day. Once the pathogen has been identified and its sensitivity determined, the dose can be reduced accordingly.
Best results with meningococcal meningitis were achieved with a treatment duration of 4 days, with meningitis caused Haemophilus influenzae - 6 days, Streptococcus pneumoniae- 7 days.
Lyme disease
50 mg/kg (highest daily dose - 2 g) for adults and children once a day for 14 days.
Gonorrhea (caused by penicillinase-forming and penicillinase-non-forming strains)
The drug 250 mg is administered intramuscularly once.
Duration of treatment
The duration of treatment depends on the course of the disease. The drug Ceftriaxone Sandoz is administered for at least 48-72 hours after the temperature has normalized and the absence of microorganisms, according to the results of the analysis.
Elderly patients
Dose adjustment of Ceftriaxone Sandoz is not required, except in cases of renal and liver failure.
Dose adjustment of Ceftriaxone Sandoz is not required for mild or moderate renal failure, provided normal function
No studies have been conducted in patients with severe renal impairment.
Patients with kidney failure
In case of renal failure in the preterminal stage (creatinine clearance less than 10 ml/min), the daily dose of Ceftriaxone Sandoz should not exceed 2000 mg.
For patients on hemodialysis, additional administration of Ceftriaxone Sandoz after dialysis is not required. Ceftriaxone is not excreted peritoneally or by hemodialysis. Clinical monitoring for safety and effectiveness is recommended.
How to use Ceftriaxone Sandoz
Ceftriaxone Sandoz can be administered by intravenous infusion over at least 30 minutes (preferred route of administration), or slowly as an intravenous bolus injection over 5 minutes, or deep intramuscularly. Bolus intravenous injections should be entered into more large veins within 5 minutes.
Infants and children under 12 years of age are administered doses of 20 - 80 mg/kg, intravenously as infusions.
Neonates should be given intravenously as an infusion over 60 minutes to reduce the potential risk of developing bilirubin encephalopathy.
Intramuscular injections should be given into large muscles, with a maximum of 1000 mg per site on one side. The possibility of intravenous administration should be considered if intramuscular administration of Ceftriaxone Sandoz is not possible. Doses exceeding 2000 mg of Ceftriaxone Sandoz should be administered intravenously.
When using lidocaine as a solvent, the solution of Ceftriaxone Sandoz should be used only in the form intramuscular injection. The information provided in the instructions for use should be taken into account medicine lidocaine. Lidocaine is not recommended as a solvent in children under 12 years of age.
Side effects
Most Frequent side effects: eosinophilia, leukopenia, thrombocytopenia, diarrhea, rash, increased liver enzymes.
hoften
- eosinophilia, leukopenia, thrombocytopenia, blood clotting disorders
Diarrheab, loose stool, nausea, vomiting, stomatitis, glossitis
- exanthema, allergic dermatitis, itching, urticaria, swelling
Increased liver enzymes
Skin rash
noften
Fungal infection of the genitals
Granulocytopenia
Coagulopathy
Headache
Dizziness
Itchy skin
Pain at the injection site
Fever
Increased blood creatinine levels
Rcaustically
- pseudocolitisb
- anaphylactic shock or anaphylactoid reactions (eg,
bronchospasm, fever, chills, edema)
Hives
Headache, dizziness, vertigo
Reversible cholelithiasis, increased liver enzymes, serum creatinine,
Hematuria, oliguria,
Glucosuria, false positives Coombsab test and galactosemia test
Overy rarely
Blood coagulation disorders
Pseudomembranous enterocolitis, gastrointestinal bleeding.
nnot known
Superinfectionb
Hemolytic anemiab
Agranulocytosis (<500 / мм)
Hypersensitivity
Convulsions
Dizzinessb
Pancreatitisb
Stomatitis
Glossitis
Gallbladder sedimentb
Kernikterus
Stevens-Johnson syndromeb, Lyell's syndrome / toxic
epidermal necrolysisb, erythema multiforme, acute
generalized exentematous pustulosis.
Pain at the injection site
Oligouria
Kidney sediment (reversible)
Increased coagulation time
False positive glucose results are not
enzymatic methods
b see section “Special instructions”.
Infections and infestations
Cases of diarrhea following ceftriaxone administration have been reported and may be related to Clostridium difficile, it is necessary to monitor the level of fluid and electrolytes in the body.
Precipitation of ceftriaxone calcium salts
Rare cases of severe side effects, and in some cases fatal, have been reported in preterm and full-term neonates (aged<28 дней), которым внутривенно вводили цефтриаксон и кальций. После вскрытия были обнаружены нерастворенные соединения кальциевой соли цефтриаксона в легких и почках. Более высокому риску образования осадков подвержены новорожденные, что связано с малым объемом крови и более продолжительным периодом полураспада цефтриаксона по сравнению с взрослыми пациентами.
Very rare cases of ceftriaxone calcium precipitate formation in the kidneys have been reported, primarily in children over 3 years of age who were administered either high daily doses of ceftriaxone (eg, >80 mg/kg/day) or total doses exceeding 10 grams and, if present, other risk factors (eg, fluid restrictions, bed rest, etc.), the risk of sediment formation increases in bedridden or dehydrated patients. This side effect may be symptomatic or asymptomatic and may lead to renal failure.
and anuria, but is reversible after discontinuation of ceftriaxone therapy.
Cases of precipitate formation of ceftriaxone calcium salt in the gallbladder have been reported, mainly in patients receiving doses higher than the recommended standard dose of Ceftriaxone Sandoz. Prospective studies in children have shown a variable incidence of sediment after intravenous administration of the drug, in some studies greater than 30%. It is likely that with a slow infusion (over 20-30 minutes) the incidence of this side effect is reduced. This side effect is usually asymptomatic, but rarely in cases where the formation of precipitation was accompanied by clinical symptoms such as pain, nausea and vomiting. In these
Contraindications
Hypersensitivity to ceftriaxone
Known severe hypersensitivity e.g. anaphylactic reactions to any beta-lactam antibiotic penicillin, monobactams and carbapenems
Newborns (especially premature ones) at risk of developing bilirubin encephalopathy
Premature newborns up to 41 weeks of age (weeks of pregnancy + weeks after birth)
Term neonates (<28 days of age) with jaundice, hyperbilirubinemia or acidosis, due to the possibility of impaired bilirubin binding. These patients are at risk of developing bilirubin encephalopathy.
If necessary (or expected to be necessary) treatment with intravenous calcium-containing solutions, including intravenous calcium-containing infusions, such as parenteral nutrition, due to the risk of ceftriaxone calcium precipitate formation (especially in neonates)
Before intramuscular injection of Ceftriaxone Sandoz with lidocaine as a solvent, contraindications associated with the administration of lidocaine should be excluded. Lidocaine-containing solutions of Ceftriaxone Sandoz cannot be administered intravenously.
Drug interactions
The use of calcium-containing solutions, such as Ringer's or Hartmann's solution, is not allowed for diluting Ceftriaxone Sandoz or for further intravenous administration, as a precipitate may form. The formation of a precipitate of ceftriaxone calcium salts can occur when mixing the drug Ceftriaxone Sandoz and calcium-containing solutions when using the same venous access.
Ceftriaxone Sandoz should not be used simultaneously with calcium-containing solutions for intravenous administration, including long-term infusions of calcium-containing solutions, for example, with
parenteral nutrition using a Y-connector. For all groups of patients, except newborns, sequential administration of the drug and calcium-containing solutions is possible with thorough rinsing of the infusion systems between infusions with a compatible liquid. Neonates are at increased risk of ceftriaxone calcium precipitate formation.
When oral anticoagulants and the drug are used simultaneously, the risk of vitamin K deficiency increases and bleeding may develop. The INR (international normalized ratio) should be carefully monitored and adequate dose adjustments of vitamin K should be used during and after treatment with the drug.
During in-vitro studies, antagonistic effects were observed when administered concomitantly with chloramphenicol.
With the simultaneous use of large doses of the drug and loop diuretics (for example, furosemide), renal dysfunction was not observed.
Probenecid does not affect the elimination of Ceftriaxone Sandoz.
Ceftriaxone Sandoz is incompatible with amsacrine, vancomycin, fluconazole and aminoglycosides.
special instructions
Hypersensitivity reactions
Fatal hypersensitivity reactions have been reported. If severe hypersensitivity reactions occur, therapy with Ceftriaxone Sandoz should be stopped immediately and appropriate emergency measures taken.
Interaction with calcium-containing drugs
There have been cases of death with the formation of sediment of calcium salts of ceftriaxone in the lungs and kidneys in premature and
full-term newborns less than 1 month old. Neonates have an increased risk of ceftriaxone calcium precipitate formation compared to patients in other age groups.
Patients of any age should not mix Ceftriaxone Sandoz or administer it simultaneously with any calcium-containing
intravenous solutions, even when using different infusion systems and different infusion sites.
For patients over 28 days of age, Ceftriaxone Sandoz and calcium-containing solutions can be administered sequentially, one after the other, if different infusion systems or administration are used.
at different sites, or if infusion sets are changed or thoroughly flushed with saline between infusions to prevent sedimentation. Patients who require continuous infusion of calcium-containing total parenteral nutrition (TPN) solutions may require the use of alternative antibiotic therapy that does not carry the risk of precipitate formation.
There are known cases of severe hemolytic anemia, including fatal cases, in adults and children.
If anemia develops, it is necessary to discontinue the drug Ceftriaxone Sandoz until the etiology of the anemia is established and to exclude anemia caused by ceftriaxone.
Long-term treatment
During long-term treatment, blood counts should be regularly monitored.
Colitis/Overgrowth of non-susceptible microorganisms
As with the use of most other antibacterial drugs, cases of diarrhea caused by ceftriaxone have been reported. Clostridium difficile, varying in severity: from mild diarrhea to fatal colitis. Therefore, it is necessary to be aware of the possibility of developing diarrhea caused by C. difficile, in all patients with diarrhea after antibiotic therapy. The possibility of stopping therapy with Ceftriaxone and switching to treatment specifically aimed at Clostridium difficile. Drugs that inhibit intestinal motility should not be used.
As with treatment with other antibiotics, superinfections may develop.
Severe renal and liver failure
In severe renal and hepatic impairment, careful monitoring of efficacy and safety is recommended.
Sodium
Each gram of Ceftriaxone Sandoz contains 3.6 mmol (or 83 mg) sodium. This should be taken into account when prescribing the drug to patients on a controlled sodium diet.
Cholelithiasis
If there are shadows in sonograms, the possibility of the formation of calcium salts of ceftriaxone should be taken into account. As a rule, after the use of ceftriaxone in a dose of more than 1 g per day, shadows were detected on sonograms of the gallbladder, which were mistaken for gallstones. Particular caution should be exercised in children and adolescents. After stopping treatment with Ceftriaxone Sandoz, these deposits of ceftriaxone calcium salts disappear.
Cholestasis
Rare cases of pancreatitis, possibly due to bile duct obstruction, have been described in patients receiving Ceftriaxone Sandoz. Most of these patients had a history of risk factors for biliary congestion, such as previous therapy, severe illness, and total parenteral nutrition. At the same time, it is impossible to exclude the triggering role of the formed sediments of calcium salts of ceftriaxone under the influence of the drug Ceftriaxone Sandoz in the biliary tract in the development of pancreatitis.
Kidney stone disease
Reversible cases of kidney stones have been reported that disappeared after completion of treatment with Ceftriaxone Sandoz. In cases of symptoms of kidney stones, an ultrasound scan should be performed. When prescribing Ceftriaxone Sandoz to patients with kidney stones or hypercalciuria, the risk-benefit ratio must be taken into account.
Pregnancy and lactation
Ceftriaxone penetrates the placental barrier.
Ceftriaxone can be prescribed during pregnancy after assessing the benefit/risk ratio, especially in the first trimester of pregnancy.
When using ceftriaxone during lactation, breastfeeding should be discontinued.
No adverse effects on reproductive function in men or women were observed during fertility studies.
Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms
Sometimes ceftriaxone can cause dizziness, which should be taken into account when driving vehicles and operating machinery.
Overdose
Symptoms: nausea, vomiting and diarrhea.
Treatment: Treatment is symptomatic. Hemodialysis or peritoneal dialysis does not affect ceftriaxone concentrations. There is no specific antidote.
Release form and packaging
500 mg or 1000 mg or 2000 mg of powder are placed in colorless glass bottles (type III, Eur. Pharm.) with a capacity of 15 ml (for a dosage of 500 mg or 1000 mg), 30 ml (for a dosage of 2000 mg) sealed with rubber stoppers, crimped aluminum caps with flip-off plastic caps.
Parents approach the selection of medications for the treatment of children with caution. Many people try not to use antibiotics for childhood illnesses. However, in some situations, for example, with pneumonia or meningitis, it is impossible to do without potent drugs. Ceftriaxone is often prescribed to children. How to use medicine for pneumonia and other diseases?
Composition and release form
Ceftriaxone is a broad-spectrum antibiotic. It belongs to the 3rd generation cephalosporins. The main substance of the drug is ceftriaxone in the form of sodium salt. The drug is available in the form of a white or dark yellow powder for making a solution. The medicine is packaged in vials, each of which contains 1 g or 2 g of ceftriaxone.
Mechanism of action
Ceftriaxone has a bactericidal and antibacterial effect. The powder dissolves well in water. The drug is suitable for intravenous and intramuscular administration. Upon penetration into the body, the substance is quickly absorbed. Half an hour after an injection into a vein and 60 minutes after an injection into a muscle, the substance reaches its highest concentration in the blood.
The effect of the drug lasts throughout the day, so it is used once a day. Penetrating into the cells of pathogenic bacteria, Ceftriaxone destroys their protective shells and does not allow the formation of new elements of pathogenic microorganisms. The drug is active against many gram-positive and gram-negative aerobes and anaerobes.
Indications for use of Ceftriaxone
Ceftriaxone is a fast-acting medicine that is easily excreted from the body, so it is used even to treat babies under one year old. The drug is used in the treatment of infectious diseases accompanied by severe inflammation. Indications for use of Ceftriaxone:
- gastrointestinal and biliary tract infections;
- bronchitis;
- pneumonia;
- meningitis;
- angina;
- diseases of the urinary system (cystitis, urethritis, kidney inflammation, pyelonephritis);
- peritonitis, sepsis;
- inflammation of the membranes of the heart;
- infection of bones and joints;
- diseases of the skin and soft tissues (carbuncles, streptoderma, erysipelas, furunculosis, pyoderma, phlegmon, staphyloderma) (we recommend reading:);
- postoperative complications;
- sinusitis, sinusitis, complicated otitis, mastoiditis;
- purulent inflammation after frostbite, burns, major injuries;
- infections in immunocompromised patients;
- Lyme disease.
Ceftriaxone is a broad-spectrum antibiotic, therefore it is used to treat many infectious diseases, but only as prescribed by a doctor. Contraindications and side effects
The drug is usually well tolerated by patients. However, it is a potent drug that penetrates deeply into the body, and therefore has a number of contraindications and side effects. Absolute contraindications include intolerance to cephalosporin, carbapenem and penicillin antibiotics. Ceftriaxone is prescribed with caution in the following cases:
- children born prematurely;
- babies weighing less than 4500 kg;
- with impaired liver and kidney function;
- with (hyperbilirubinemia);
- with intestinal inflammation.
Sometimes a hematoma forms at the injection site. However, this phenomenon is not related to the drug, but is a consequence of improper procedure.
When an antibiotic is administered, the patient may experience pain at the injection site, but this usually goes away quickly. Other side effects of the drug include:
- nausea and vomiting;
- change in stool frequency (diarrhea, constipation);
- lack of appetite, changes in taste sensations;
- bloating, increased gas formation;
- heartburn;
- dysfunction of the liver and kidneys;
- weakness, drowsiness, lethargy;
- dizziness, headache;
- convulsions;
- stomatitis;
- skin rashes and itching;
- Quincke's edema, anaphylactic shock;
- disruption of the hematopoietic system (thrombocytopenia, anemia, granulocytopenia, thrombocytosis, neutropenia, etc.);
- blood in urine;
- coating on the tongue;
- enterocolitis;
- dysbacteriosis;
- nosebleeds.
Special instructions and interactions with other drugs
Injections must be given by a qualified medical professional in a hospital setting A feature of the use of Ceftriaxone is that injections are given only in a hospital setting. The drug must be administered slowly, so it is not recommended to inject it into a child yourself. When treating a child with an antibiotic, it is necessary to constantly monitor his blood counts and monitor the body's response to the medicine.
With long-term treatment, the patient may develop an addiction to Ceftriaxone, in which the infection will stop responding to it and degenerate into a superinfection. Also, long-term antibiotic therapy can cause a decrease in beneficial intestinal microflora and dysbacteriosis. Ceftriaxone should not be mixed with drugs that contain calcium.
The medicine cannot be administered in parallel with other antibiotics, since such a combination will lead to adverse reactions and intoxication of the body. It is not recommended to use an antibiotic with diuretics - this is fraught with renal failure. When taking Ceftriaxone simultaneously with blood thinning medications, bleeding may develop.
Instructions for use of Ceftriaxone for children
According to the instructions, before use, Ceftriaxone must be diluted with water for injection, Lidocaine, glucose, and saline solution. An anesthetic reduces pain during injection. However, before using Lidocaine, children need to do a drug tolerance test.
The table describes the volume of solvents needed to prepare the solution.
When administered intravenously, Ceftriaxone is administered slowly (2-4 minutes), by drip - for at least 30 minutes. Intramuscular injections are made deep into the upper outer part of the buttock. The use of Ceftriaxone together with Lidocaine in children increases the possibility of allergic reactions, so many doctors prefer to dilute the drug with water for injection (for intramuscular administration).
Experts do not recommend diluting the medicine with Novocaine. This painkiller reduces the effectiveness of Ceftriaxone, and when using Novocaine to treat children, there is a possibility of developing anaphylactic shock after administration of the drug. If it is not possible to use another solvent, then take 5 ml of anesthetic per 1 g of Ceftriaxone.
The duration of antibiotic treatment depends on the cause and severity of the disease and ranges from 4-14 days. The dosage for children is determined depending on the age and weight of the patient.
The frequency of use is determined by the doctor. When treating various diseases, it is up to twice a day.
The dosage of Ceftriaxone for children of different ages is described in the table.
Sometimes Ceftriaxone is prescribed to a child with sinusitis as part of complex nasal drops. To prepare the solution, mix 1 g of antibiotic, 1 ml of Nazivin, 5 ml of Furacilin and 1 ml of Hydrocortisone. Drops are not allowed to be used by children under two years of age. The nose is instilled for 4–7 days.
Price and similar products
Ceftriaxone is sold in packages of 10, 20, 50 pcs. You can also buy 1 or several bottles of the drug. Its price ranges from 16 to 40 rubles per bottle. There are many analogues of the drug. However, medications containing ceftriaxone are not available in tablets or other forms. Some analogues of the drug are supplied with a solvent, but this significantly increases their price.
The substance ceftriaxone is included in the following drugs: Rocephin, Cefson, Cefogram, Cefaxone, Biotraxone, Torocef, Cefatrin, Tercef, Movigip, Megion, Hizon. Sometimes painful injections become a serious obstacle to the treatment of a child. In such cases, doctors select antibiotics in a different form. Drugs that can replace Ceftriaxone are described in the table.
| Name | Active substance | Release form | Indications for use |
| Cephalexin (see also:) | cephalexin | Tablets, capsules, granules for suspension preparation | Pneumonia, tonsillitis, bronchitis, pyelonephritis, skin infections, joint and bone diseases, meningitis |
| Amoxiclav | amoxicillin, clavulanic acid | Suspension, tablets | Inflammation caused by bacteria |
| Amoxicillin | amoxicillin | Suspension | Diseases of the lower respiratory tract, ENT organs, peritonitis, urethritis, purulent skin infections, sepsis |
| Cefaclor | cefaclor | Tablets, suspension, dragees, powder for dilution | Respiratory tract infections, pyelonephritis, sinusitis, skin and soft tissue lesions |
When choosing a method of treating infectious pathologies in a child, experts give preference to drugs that quickly eliminate the cause of the disease. Despite the pain of administration and possible side effects, Ceftriaxone is an effective medicine. It is not prescribed for the purpose of prevention, but is used if other means are unable to overcome the infection.
Price for Ceftriaxone (1 g): 30-50 rubles.
Instructions for use
The drug Ceftriaxone belongs to a group of antibiotics aimed at a wide range of effects on diseases of different origins and degrees of neglect.
Ceftriaxone for children under one year of age
A huge number of side effects is not a reason to prohibit the use of the drug for children under one year of age.
If it is necessary to prescribe Ceftriaxone to children of this age group, all recommended instructions and appropriate dosages should be taken into account.
If the slightest, even the most insignificant, signs of side effects appear, you should immediately stop taking the drug.
Ceftriaxone: indications for use in children
If a child develops diseases such as infections of the joint and skeletal system, peritonitis and other infections of the gastrointestinal tract, infectious diseases of the renal and urinary systems, pneumonia, sepsis of any etiology, skin infections, the appointment of Ceftriaxone is an integral part of the treatment, the tactics of which should only be determined by a doctor.
Ceftriaxone: side effects in children
The drug Ceftriaxone can cause many side effects, as it is a powerful antibiotic.
- Reaction from the circulatory system - the occurrence of anemia, neutropenia, leukopenia, etc.
- Reaction from the urinary system – anuria, azotemia, cylindruria, hematuria.
- Possible allergic manifestations are chills, fever, itching, erythema and even anaphylactic shock.
- From the digestive system - vomiting, constipation, enterocolitis, dysbacteriosis, nausea.
Sometimes a child may feel pain at the injection site of Ceftriaxone, periodic headaches, dizziness, and nosebleeds.
Ceftriaxone: dosage for children
The dosage of Ceftriaxone always depends on the age characteristics of the child.
The following distribution of doses taken is accepted:
- if the baby’s age is from 0 to 2 weeks, then the required dosage will be 20-50 mg per 1 kg of the child’s body weight once a day;
- for children aged from 15 days to 12 years, Ceftriaxone is taken once a day and is measured at 20 – 80 mg per 1 kg of the child’s body weight;
- For adolescents whose body weight is more than 50 kg, the dosage taken by adults can be recommended, i.e. 1 – 2 g once a day. The prescribed dose should not exceed a threshold of more than 4 grams.
Antibiotic Ceftriaxone: how to give injections for children
To dilute the drug Ceftriaxone in powder, you can use ordinary water. At the same time, lidocaine should not be used, as it negatively affects the heart and causes convulsions in the child. Also, you cannot combine Ceftriaxone with Novocaine, since such a consistency can cause anaphylactic shock in the baby.
Ceftriaxone: injections for children
When a doctor’s prescription is based on the administration of Ceftriaxone by injection, the question immediately arises of how exactly to administer the drug to children. For intravenous administration, 0.5 g of Ceftriaxone is diluted into 5 ml of purified aqueous solution. To relieve the pain from the injection as much as possible, you need to do it slowly, about a few minutes.
How many days should a child be injected with Ceftriaxone?
The treatment period with Ceftriaxone usually lasts from 10 days to two weeks. If clinical improvements do not occur while taking the drug within the expected time, then it must be changed to another.
We must not forget that the drug Ceftriaxone is a powerful antibiotic, so it should be taken under the constant supervision of a pediatrician to reduce the likelihood of side effects.
: How to dilute Ceftriaxone.
Source: http://nedeli-beremennosti.com/ceftriakson-dlya-detej/
Antibiotic Ceftriaxone - release form and dosage for a child or adult, contraindications and reviews
Infectious diseases caused by bacteria require immediate treatment.
According to reviews from patients and doctors, the antibiotic Ceftriaxone, which is injected into a vein or muscle, gives excellent results; the main thing is to take into account contraindications and side effects.
How the medicine works, what indications for use it has, the correct dosages and methods of use - everything is detailed in the annotation to the medicine.
Instructions for use of Ceftriaxone
The drug is a semi-synthetic antibiotic of the third generation cephalosporin group. It has a bactericidal effect and a wide spectrum of action. Medicine Ceftriaxone:
- inhibits cell wall synthesis in bacteria;
- penetrates through biological barriers into liquids and tissues;
- is in the blood in high concentration;
- suppresses bacterial cell membranes;
- destroys microorganisms resistant to penicillin;
- active against aerobic and anaerobic bacteria, gram-positive and gram-negative microorganisms.
Instructions for use of the drug stipulate the composition and form of release, methods of use. Ceftriaxone is used only as prescribed by a doctor, who takes into account:
- duration of treatment;
- indications;
- dosage;
- contraindications;
- animal treatment;
- interaction with alcohol and other drugs;
- antibiotic analogues.
Compound
According to the instructions for use, Ceftriaxone is a slightly hygroscopic, finely crystalline powder that has a white or yellowish color. The product is used to prepare a solution for intramuscular and intravenous injections by diluting the drug with special solvents. The medicine contains sodium soda in its chemical composition.
Release form
The antibiotic is used only for parenteral administration, therefore it is available in powder form for the preparation of a solution for injection. The composition is packaged in bottles of 0.5, 1 and 2 grams. Ceftriaxone is not produced in the form of tablets, capsules, or suspensions. This is because the antibiotic:
- exhibits high activity when administered orally;
- irritates tissues and mucous membranes.
Pharmacodynamics and pharmacokinetics
Successful treatment depends on the sensitivity of microorganisms to antibiotics. Ceftriaxone has a wide spectrum of action. Note properties:
- activity against strains of enterococci;
- counteraction to gram-positive aerobes Epidermidis, Streptococcus;
- activity against anaerobes Bacteroides fragilis, Peptostreptococcus spp.;
- counteracting gram-negative aerobes Escherichia col, Morganella morganii;
- after administration, the drug is absorbed into the blood, penetrates into tissues and organs;
- after 48 hours it is excreted in the kidneys and bile.
Indications for use
The instructions stipulate the effectiveness of the antibiotic against bacterial infections. Therapy with Ceftriaxone has a positive effect in the treatment of diseases caused by pathogenic microorganisms. These include infections:
- abdominal organs;
- upper respiratory tract;
- genitourinary system;
- bones and joints;
- skin, soft tissues
- maxillofacial region.
Indications for the use of intravenous and intramuscular antibiotic injections are:
- inflammation of the gastrointestinal tract;
- peritonitis;
- angina;
- treatment of sinusitis;
- lung abscess;
- pneumonia;
- wounds and burns;
- infectious kidney diseases;
- pyelonephritis;
- treatment of gonorrhea;
- sepsis;
- bacterial meningitis;
- chancroid;
- syphilis;
- borreliosis;
- salmonellosis;
- intestinal infections;
- typhoid fever;
- cystitis;
- prostatitis;
- cystitis;
- bronchitis;
- epididymitis;
- prevention of infection after surgery.
Contraindications
The drug is a strong antibacterial drug. When prescribing a medicine, doctors must follow the instructions, which stipulate a ban on its use. Ceftriaxone is contraindicated in the following cases:
- high sensitivity to antibiotic ingredients;
- vulnerability to penicillins, carbapenems, and other cephalosporins;
- pregnancy;
- prematurity;
- the presence of hyperbilirubinemia in the infant;
- liver failure;
- enteritis;
- colitis;
- kidney failure;
- lactation.
Directions for use and dosage
Ceftriaxone is used intravenously - in the form of injections, droppers or intramuscularly into the buttock. The dosage is prescribed by the doctor in accordance with the diagnosis, age of the patient, and severity of the disease. The antibiotic is administered once a day or every 12 hours. The instructions give recommendations for dosage in mg of powder:
- for children over 12 years of age and adults – 1000-2000, 1 time per day;
- the maximum for this period is 4000.
What to breed
Antibiotic injections must be given with a freshly prepared mixture. To administer the injection, you must first dilute Ceftriaxone with a solvent. Several substances are used for this. How is antibiotic dissolution done? To this end:
- use distilled water for injection - if you are allergic to other medications;
- use a solution of Lidocaine 2%;
- diluted with Novocaine to reduce pain;
- make a combination of Lidocaine with water or sodium chloride solution.
Duration of treatment
According to the instructions, only a doctor can prescribe an antibiotic. The duration of treatment is determined in accordance with the severity and nature of the disease. The infectious agent plays an important role. There are treatment features:
- if it is gram-negative Neisseria diplococci, the patient will recover in 4 days;
- for enterobacteria sensitive to antibiotics – two weeks.
special instructions
The instructions for use stipulate special points that need to be paid attention to when using the antibiotic Ceftriaxone. Following the rules will help avoid complications. Important points:
- you must be prepared to provide emergency care if anaphylactic shock occurs;
- Regular monitoring of the drug concentration in the blood plasma of patients with both severe liver and kidney failure and undergoing hemodialysis is required.
When an antibiotic is administered intravenously or intramuscularly, the following must be considered:
- elderly and weakened patients require vitamin K;
- When performing an ultrasound of the gallbladder, it is possible that darkening may appear, disappearing after the procedures are completed;
- in case of pain in the hypochondrium on the right, it is necessary to carry out symptomatic therapy and continue treatment with Ceftriaxone.
During pregnancy
Unfortunately, waiting for a baby can be complicated by infectious diseases. Is it possible to use Ceftriaxone solutions during breastfeeding and pregnancy? Since the drug can reach the newborn through milk, in order to avoid unpleasant consequences, it is advisable:
- do not use antibiotics for treatment at this time;
- in case of urgent need, the child must be switched to artificial feeding for the duration of the procedures.
According to doctors, pregnancy is a period when it is better to stop using Ceftriaxone. A situation may arise that infections will be much more dangerous for the expectant mother’s body than the consequences of the disease and the use of an antibiotic. The decision in this case is made by the gynecologist. Please note:
- contraindications available for treatment;
- a complete ban occurs in the first trimester of pregnancy, when the formation of fetal systems and organs occurs.
In childhood
Ceftriaxone for children has its own application characteristics. It is important to strictly observe the dosage of the drug and the duration of the course.
It is better if intramuscular and intravenous injections are given to the child in a hospital under the supervision of doctors. The daily norm should not exceed 4 grams.
If children weigh more than 50 kg, the procedure is carried out in the form of droppers for half an hour. According to the instructions, the doses of Ceftriaxone are per kilogram of body weight per day in mg:
- for newborns up to two weeks - maximum 50;
- a child under 12 years old – from 20 to 80.
Ceftriaxone is prescribed to children in accordance with the diagnosis and severity of the disease; the duration of the course of treatment is determined by the pediatrician. If a child weighs more than 50 kg, he receives the dosage of the drug as an adult patient. Depending on the pathology, mg of Ceftriaxone is prescribed per kilogram of body weight per day:
- for bacterial meningitis - 100 at a time;
- for severe infections – 25-37.5, every 12 hours;
- for skin diseases – 50-75 per procedure.
For animals
In veterinary medicine, the drug is used for bacterial complications in animals. For injections, the antibiotic is diluted with Lidocaine with a drug concentration of 2% and water for injection.
The medicine is administered intramuscularly or subcutaneously. If necessary, intravenously through a catheter. In this case, the powder must be diluted with sterile distilled water.
The dosage is calculated in milligrams per kilogram of weight and is:
- small animals – kittens, cats – 0.16;
- for dogs and other large specimens – up to 50.
Interaction with other drugs
The instructions for the drug Ceftriaxone stipulate its interaction with other drugs when used simultaneously. When prescribing an antibiotic, doctors must take into account the specific effects of drugs on each other. Note the properties of the drug Ceftriaxone:
- together with aminoglycosides, the effect against gram-negative bacteria is enhanced;
- with loop diuretics there is a risk of toxic kidney damage;
- with non-steroidal anti-inflammatory drugs, bleeding cannot be ruled out;
- incompatibility with other antibiotics.
Ceftriaxone INN
Belongs to the category of 3rd generation broad spectrum cephalosporin antibiotics.
Release form: injection drug. Powder for creating a solution for intravenous and intramuscular administration.
Storage conditions: in a dry place, out of direct sunlight. At temperatures less than 25°.
Shelf life: 3 years.
The minimum price for Ceftriaxone is 45 rubles. Before purchasing, you should compare the cost of Ceftriaxone in pharmacies in St. Petersburg.
pharmachologic effect
It has a bactericidal and antibacterial effect due to the destruction of elements of the cell membrane of the pathogenic bacterium. It is characterized by high activity against aerobic gram-positive (streptococci, staphylococci), gram-negative (enterobacteria, Escherichia, Haemophilus influenzae, Klibsiella, Proteus, etc.) microorganisms and anaerobes (clostridium, etc.).
The drug has a destructive effect on multi-resistant strains resistant to penicillins, aminoglycosides, 1st and 2nd generation cephalosparins. After intramuscular administration, absorption occurs. The period of final disintegration and achievement of maximum concentration occurs 2-3 hours after the drug enters the blood.
Indications and contraindications
- Infection of the abdominal organs (peritonitis, inflammation of the gastrointestinal tract and biliary tract).
- Damage to the respiratory tract and ENT organs.
- Infection of bones, joint cavities, skin and soft tissues.
- Infection of the urinary and reproductive systems (pyelonephritis, gonorrhea, etc.).
- Epiglottitis.
- Meningitis of bacterial etiology, sepsis.
- Infection of wound and burn surfaces.
- Syphilitic chancre.
- Tick-borne borreliosis.
- Salmonellosis and passive carriage of the disease.
- Prevention of the development of an infectious process in the wound surface after major or minor operations.
- High risk of infection in people with immunodeficiency.
Dosage and method of administration
Used for intravenous and intramuscular administration. Persons over 12 years of age are prescribed a daily dose of 1-2 g or 0.5-1 g every 12 hours. The maximum permissible daily dosage is 4 g. When a dose of more than 50 mg/kg is prescribed, the medicine is injected into a vein over half an hour. The duration of the therapeutic course is selected individually.
Only freshly prepared ready-made medication can be administered. When administered intravenously, 0.25 or 0.5 g of the active substance must be dissolved in 5 ml of an aqueous solution for injection. The speed should be low (minimum 2-4 minutes). For intravenous infusion, you will need to dissolve 2 g in 40 ml of calcium-free solution. A dose of 50 mg/kg or more should be administered intravenously over half an hour.
Side effects
If the dosage is increased or medical recommendations are not followed, the following negative consequences may develop:
- Nervous system: dizziness, headache and convulsions.
- CVS and hematopoietic system: increased leukocytes, platelets, monocytes, basophils and eosinophils, decreased concentration of neutrophils and lymphocytes, nosebleeds.
- Gastrointestinal tract: dyspeptic disorders (nausea, vomiting), stool disorders with predominance of diarrhea, transient increase in transaminases, increased concentration of alkaline phosphatase or bilirubin, abdominal pain, jaundice.
- Urinary and reproductive systems: increased urea nitrogen in the bloodstream, increased creatinine levels and the presence of casts in the urine, red blood cells and glucose in the urine.
- Allergic manifestations: skin rash, anaphylactic shock, itching, burning, febrile syndrome.
- The rest: fungal infection, increased sweating, increased blood flow to the facial area. Locally, it is possible to develop pain and swelling at the injection site.
There is no specific antidote. If an excessive concentration of the drug is used, it is necessary to immediately stop its administration and begin symptomatic therapy. Hemodialysis and peritoneal dialysis are ineffective in this situation.
