Also Known As: Rocephin, Ceftriaxone

Ceftriaxone (INN) is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria. In most cases, it is considered to be equivalent to cefotaxime in terms of safety and efficacy. Ceftriaxone sodium is marketed by Hoffman-La Roche under the trade name Rocephin.

Ceftriaxone is often used (in combination, but not direct, with macrolide and/or aminoglycoside antibiotics) for the treatment of community-acquired or mild to moderate health care-associated pneumonia. It is also a choice drug for treatment of bacterial meningitis. In pediatrics, it is commonly used in febrile infants between 4 and 8 weeks of age who are admitted to the hospital to exclude sepsis. The dosage for acute ear infection in the very young is 50 mg/kg IM, one dose daily up to three days. It has also been used in the treatment of Lyme disease, typhoid fever and gonorrhea.[1]

Intravenous dosages may be adjusted for body mass in younger patients and is administered every 12–24 hours, at a dose that depends on the type and severity of the infection.

For the treatment of gonorrhea, a single intramuscular injection is usually given. According to the Journal of Family Practice, Volume 60, NO 12, December 2011; the intramuscular dose of ceftriaxone (Rocephin) has been increased from 125mg IM to 250mg IM due to increasing resistance of the gonococcal bacteria. It is also recommended that 1000mg of azithromycin be given orally at the same time for dual treatment. This also takes care of treatment of underlying chlamydia since treatment for chlamydia infection is also recommended. It must not be mixed or administered simultaneously (within 48 hours) with calcium-containing solutions or products for patients younger than 28 days old,[2] even via different infusion lines (rare fatal cases of calcium-ceftriaxone precipitates in lung and kidneys in neonates have been described).[3]

To reduce the pain of intramuscular injection, ceftriaxone may be reconstituted with 1% lidocaine.[4]

Ceftriaxone has also been investigated for efficacy in preventing relapse to cocaine addiction.[5]

Ceftriaxone seems to increase EAAT2 pump expression in central nervous system and has therefore a potential to reduce glutamatergic toxicity.[6] Despite earlier negative results in 1990s, new, large clinical trials are underway to test its effacy in Amyotrophic lateral sclerosis (ALS) patients.

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