Ceftriaxone
⚠️ About 1–6% of penicillin-sensitive patients will also be allergic to cephalosporins.
❌ Those with a history of immediate hypersensitivity to penicillin or other beta-lactams should not receive cephalosporins.
⚠️ Cephalosporins should be used with caution in patients with any beta-lactam sensitivity.
📖 About
Always check the BNF link here.
- 💊 3rd Generation Cephalosporin (beta-lactam antibiotic).
⚙️ Action
- 🔗 Inhibits peptidoglycan cross-linking → prevents bacterial cell wall formation.
- 🦠 Bactericidal mechanism.
🌍 Activity
- ✅ Good Gram-negative cover.
- ⬇️ Less effective against Gram-positive organisms compared with 1st/2nd generation agents.
💉 Indications
- 🏥 Severe infections: septicaemia, meningitis, pneumonia, biliary sepsis, peritonitis, UTIs.
- 🧠 Bacterial meningitis, HACEK endocarditis, CAP/HAP, sepsis: 1–2 g IV/IM BD.
- 💧 Moderate infection: 500 mg–1 g IV BD for 7–10 days.
- ❤️ HACEK endocarditis: 2–4 g daily IV infusion.
- 👩❤️👨 Uncomplicated gonorrhoea: 250 mg IM single dose (⚠️ no activity vs. Chlamydia trachomatis → treat separately).
- 🔪 Surgical prophylaxis: 1 g IV single dose 1 hour pre-procedure.
📊 Dose Range (check BNF / datasheet)
| Indication | Dose | Frequency | Route |
|---|
| Moderate infection | 1 g | BD | IV / IM |
| Severe infection | 2 g | BD | IV / IM |
🔄 Interactions
- ⚠️ May increase effect of warfarin → monitor INR closely.
⚠️ Cautions
- 🚫 Allergy to penicillin or cephalosporins.
- 💧 Renal impairment (dose adjustment in AKI/CKD).
- 🧪 False-positive urine glucose and Coombs’ test possible.
- 💉 IV formulations may contain high sodium/potassium load.
⛔ Contraindications
- Severe hypersensitivity to beta-lactams (penicillin or cephalosporin).
💥 Side Effects
- 🤢 GI: diarrhoea, antibiotic-associated colitis, nausea, vomiting, pancreatitis.
- 🌡️ Allergic: rash, urticaria, Stevens–Johnson syndrome, TEN, anaphylaxis.
- 🧪 Hepatic: hepatitis, cholestatic jaundice.
- 🩸 Haematological: ↓ WCC, platelets, granulocytes, aplastic anaemia.
- 💧 Renal: interstitial nephritis.
- 🧠 CNS: headache, delirium (rare).
