- Third generation cephalosporin for treatment of susceptible strains of bacteria
- Long half-life (8 hours) makes it suitable for outpatient therapy of other infections
- Has been recommended as current outpatient therapy of choice for all forms of gonorrhea (active against penicillinase-producing strains of N. gonorrhea)
|
VIAL SIZE |
STERILE WATER for INJECTION REQUIRED |
FINAL CONCENTRATION |
|
1,000 mg |
9.6 mL |
100 mg/mL |
|
2,000 mg |
19.2 mL |
100 mg/mL |
|
10,000 mg |
95 mL |
100 mg/mL |
- Store unreconstituted vial at room temperature, protect from light
- Reconstituted vial and solution for IV use stable 3 days room temperature, 10 days refrigerated
- Solution colour ranges from light yellow to amber, depending on length of storage
- May precipitate but goes back into solution at room temperature
For IM use:
* Dilute 1000 mg vial with 1.8 mL lidocaine 1% or 2000 mg vial with 3.6 mL lidocaine 1% for 500 mg/mL. Stable 24 hours at room temperature or 72 hours refrigerated
- Solutions Compatible: dextrose up to D10W, 0.9% NS, dextrose-saline combinations
- Additives/Above Cassette Compatible: lidocaine 1% (without epinephrine) for IM injection
- Y-site Compatible: Intralipid 20% , morphine, potassium chloride
Incompatible: calcium, fluconazole, vancomycin, aminoglycoside antibiotics: administration of beta lactam and aminoglycoside antibiotics should be separated.
No calcium or calcium-containing IV medications (ie. TPN and Lactated Ringers) should be given simultaneously via a Y-site. In term patients that are older than one month (excluding neonates), ceftriaxone and calcium containing solutions may be administered sequentially of one another if the infusions lines are thoroughly flushed between infusions with a compatible fluid.
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM |
YES, deep into large muscle |
| IV Direct |
Yes. Max 2 g/dose IV direct Usual dilution: 100 mg/mL Infusion time: 3-5 minutes |
| IV Intermittent Infusion | YES - preferred Usual dilution: 100 mg/mL Infusion time: 10-30 minutes |
| IV Continuous Infusion | NO |
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
PEDIATRIC: (IV/IM)
- Contraindicated until child is term plus 1 month of age
- 50 - 100 mg/kg/day IV divided Q 12 - 24H (Max 2 g/dose)
- Meningitis: refer to CHEO Meningitis (Bacterial) Treatment Guidelines
At 0 hours - loading dose of 100 mg/kg/dose (Max 2 g/dose),
At 12 hours - another loading dose of 100 mg/kg /dose
At 24 hours - start 100 mg/kg/day IV divided Q12H (Max 2 g/dose or 4 g/day)
- Uncomplicated Gonorrhea
- 250 mg IM as a single dose
ADOLESCENTS/ADULTS:
- 1-2 g IM/IV Q 12-24 hours (Max 2 g/dose)
- Hypersensitivity reactions: rash, pruritus, bronchospasm, anaphylaxis
- Possible cross-sensitivity with other beta-lactam antibiotics (ie. penicillins, cephalosporins)
- Local reactions at injection site: pain, induration and tenderness, thrombophlebitis
- Gastrointestinal: diarrhea, nausea, vomiting
- Laboratory abnormalities: eosinophilia, thrombocytosis, transient elevations in hepatic enzymes, BUN or serum creatinine
- Sodium content is 3.6 mmol/g of ceftriaxone
- Not necessary to reduce dose except where renal and hepatic insufficiency co-exist
- Monitor CBC with differential, renal and hepatic function tests, PT