CEFTRIAXONE injectable

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    Last updated: October 2022

     

    Prescription under medical supervision

     

    Therapeutic action

    • Third-generation cephalosporin antibacterial

    Indications

    • Severe bacterial infections: meningitis, pneumonia, typhoid fever, shigellosis, leptospirosis, tick-borne relapsing fevers, pyelonephritis, neurosyphilis, etc.
    • Cervicitis, urethritis and conjunctivitis due to Neisseria gonorrhoeae (in combination with a treatment for chlamydia, except in neonates), chancroid

    Forms and strengths, route of administration

    • Powder for injection, in 250 mg or 1 g vials, to be dissolved:
      • with the solvent containing lidocaine for IM injection only. DO NOT ADMINISTER BY IV INJECTION OR INFUSION the solution reconstituted with this solvent.
      • with water for injection for slow IV injection (3 minutes) or infusion (30 minutes) in 0.9% sodium chloride or 5% glucose

    Dosage and duration

    Severe bacterial infections

    • Child 1 month and over: 50 to 100 mg/kg once daily (max. 2 g daily and 4 g daily for typhoid fever and meningitis)
    • Adult: 1 to 2 g once daily (up to 2 g once daily or 2 times daily for typhoid fever and meningitis)

    Duration varies according to indication and clinical response. 

     

    Gonococcal cervicitis and urethritis, chancroid

    • Child under 45 kg: 125 mg IM single dose
    • Child 45 kg and over and adult: 500 mg IM single dose (250 mg IM single dose for chancroid)

     

    Gonococcal conjunctivitis

    • Neonate: 50 mg/kg IM single dose (max. 125 mg)
    • Adult: 1 g IM single dose

     

    For administration by IV route, ceftriaxone powder is to be reconstituted in water for injection only. For administration by IV infusion, dilute each dose of ceftriaxone in 5 ml/kg of 0.9% sodium chloride or 5% glucose in children less than 20 kg and in a bag of 100 ml of 0.9% sodium chloride or 5% glucose in children 20 kg and over and in adults.

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with allergy to cephalosporins or penicillins (cross-sensitivity may occur) and to neonates with jaundice (risk of bilirubin encephalopathy) or receiving calcium gluconate (risk of precipitation of ceftriaxone-calcium salts in lungs and kidneys). 
    • Administer with caution in patients with hepatic or renal impairment. Reduce dosage in patients with severe renal impairment (max. 50 mg/kg daily or 2 g daily in IV).
    • May cause: gastrointestinal disturbances, hepatic dysfunction, blood disorders (anaemia, leucopenia, neutropenia), renal dysfunction; allergic reactions sometimes severe (Stevens-Johnson syndrome).
    • Do not mix ceftriaxone with calcium-containing solutions such as ringer lactate (risk of particulate formation).
    • Pregnancy: no contra-indication
    • Breast-feeding: no contra-indication

    Remarks

    • Doses greater than 1 g IM should be administered in 2 equally divided injections (one in each buttock).
      Doses greater than 2 g should be administered by IV infusion only.
    • Do not mix with another drug in the same syringe or infusion.

    Storage

     

    –  Below 25 °C 
    Once reconstituted, the solution must be used immediately.