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Therapeutic indications
treatment of the following infections either before the infecting ,organism has been identified or when known to be caused by bacteria of established sensitivity.
Pneumonia ·Septicaemia ·Meningitis ·Skin and soft tissue infections ·Infections in neutropenic patients ·Gonorrhoea ·Peri-operative prophylaxis of infections associated with surgery ·Treatment may be started before the results of susceptibility tests are known.
·Consideration should be given to official guidance on the appropriate use of antibacterial agents.
Dose and method of administration
Adults and children 12 years and over:
Standard therapeutic dosage: 1g once daily.
Severe infections: 2-4 g daily, normally as a once daily dose.
The duration of therapy varies according to the course of the disease. As with antibiotic therapy in general, administration of ceftriaxone should be continued for a minimum of 48 to 72 hours afterthe patient has become afebrile or evidence of bacterial eradication has been obtained.
Acute, uncomplicated gonorrhoea: One dose of 250mg intramuscularly should be administered. Simultaneous administration of probenecid is not indicated.
Peri-operative prophylaxis: Usually one dose of 1g given by intramuscular or slow intravenous injection. In colorectal surgery, 2g should be given intramuscularly (in divided doses at different injection sites), by slow intravenous injection or by slow intravenous infusion, in conjunction with a suitable agent against anaerobic bacteria.
Standard therapeutic dosage: 20-50mg/kg body-weight once daily.
Up to 80mg/kg body-weight daily may be given in severe infections, except in premature neonates where a daily dosage of 50mg/kg should not be exceeded. For children with body weights of 50kg or more, the usual dosage should be used. Doses of 50mg/kg or over should be given by slow intravenous infusion over at least 30 minutes. Doses greater than 80mg/kg body weight should be avoided because of the increased risk of biliary precipitates.
Method of administration:
ceftriaxone and calcium-containing solutions must not be mixed or administered simultaneously.
Intramuscular injection: 1g ceftriaxone should be dissolved in 3.5ml of 1% Lidocaine InjectionBP.
The solution should be administered by deep intramuscular injection. Doses greater than 1g should be divided and injected at more than one site.
Intravenous injection: 1g ceftriaxone should be dissolved in 10ml of Water for Injections PhEur.
The injection should be administered over at least 2-4 minutes, directly into the vein or via the tubing of an intravenous infusion.