Antimicrobials
Ceftriaxone

Ceftriaxone

High
N/A
IV: $

General Information

Empiric therapy of bacterial meningitis, complicated community acquired pneumonia, nosocomial Gram negative infections (except Pseudomonas)

Due to the risk of ceftriaxone-calcium precipitates, which have caused serious cardiopulmonary events in infants, ceftriaxone must not be mixed or administered simultaneously with calcium containing IV solutions, including parenteral nutrition, neither co-administered nor via Y-site.

Neonatal Contraindications:

  1. Hyperbilirubinemia: In vitro studies have shown displacement of bilirubin from albumin binding sites which may increase risk for bilirubin encephalopathy.
  2. Calcium Containing IV Solutions: DO NOT co-administer with calcium containing IV solutions or products, including parenteral nutrition solutions which contain calcium, even when they are administered via different infusion lines at different sites. In neonates cases of fatal reactions with ceftriaxone-calcium salt precipitates in lung and kidneys have been described. Calcium containing IV solutions or products are not to be administered within 48H of last dose of ceftriaxone.
  • Injection: 0.25g, 1g, 2g vials
  • Neonatal: 250mg, 1000mg vial
  • For IM USE ONLY, ceftriaxone may be reconstituted with 1% lidocaine
  • Infants > 28 days & children: ceftriaxone and calcium-containing solutions may be administered sequentially to one another if the infusion lines are thoroughly flushed between infusions with a compatible fluid
  • Ceftriaxone displaces bilirubin from albumin binding sites which can result in hyperbilirubinemia; use caution in neonates

Antimicrobial class: Parenteral Cephalosporin - 3rd Generation

Average serum half life:

  • Neonates: 1-4 days: 16 hours; 9-30 days: 9 hours
  • Pediatrics: 4-6.6h

Route of Elimination: Unchanged in the urine (33-67%) by glomerular filtration and in feces via bile