Ceftriaxone

From Drugs Prescribing Information
(Redirected from Cefaxone)
Jump to: navigation, search
Click on "►" to expand:

Contents

[edit] BRAND NAMES

[edit] STRUCTURE

Ceftriaxone.jpg

[edit] MECHANISM OF ACTION

Ceftriaxone is a third-generation cephalosporin antibiotic with broad-spectrum activity against Gram-positive bacteria and expanded Gram-negative coverage compared to second-generation agents.

Cephalosporins are Beta-Lactam drugs that are bactericidal agents that inhibit bacterial cell wall synthesis by binding to one or more of the pencillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. (See Cephalosporin mechanism of action)

[edit] INDICATIONS

Treatment of the following infections when caused by susceptible organisms:

  • lower respiratory tract infections
  • acute bacterial otitis media
  • skin and skin structure infections
  • urinary tract infections
  • uncomplicated gonorrhea
  • pelvic inflammatory disease
  • bacterial septicemia
  • bone and joint infections
  • intra-abdominal infections
  • meningitis
  • surgical prophylaxis

[edit] DOSAGE

ADULTS: The usual adult daily dose is 1 to 2 grams given IV/IM once a day (or in equally divided doses twice a day) for 4-14 days, depending on type and severity of infection

PEDIATRIC PATIENTS <12 years:

  • Acute Bacterial Otitis Media: 50 mg/kg IM in single dose; not to exceed 1 g
  • For the treatment of skin and skin structure infections, the recommended total daily dose is 50 to 75 mg/kg given once a day (or in equally divided doses twice a day). The total daily dose should.not exceed 2 grams.
  • For the treatment of serious miscellaneous infections other than meningitis, the recommended total daily dose is 50 to 75 mg/kg, given in divided doses every 12 hours for 4-14 days. The total daily dose should not exceed 2 grams.

for more informations about

[edit] CONTRAINDICATIONS

  • Patients with known allergy to the cephalosporin class of antibiotics
  • Neonates (≤28 days): ceftriaxone can displace bilirubin from serum albumin. It should not be administered to hyperbilirubinemic neonates, especially prematures.
  • Ceftriaxone is contraindicated in neonates if they require (or are expected to require) treatment with calcium-containing IV solutions, including continuous calcium containing infusions such as parenteral nutrition because of the risk of precipitation of ceftriaxone-calcium. Cases of fatal reactions with ceftriaxone-calcium precipitates in lung and kidneys in neonates have been described.

[edit] PRECAUTIONS

  • Clostridium difficile associated diarrhea : Treatment with Ceftriaxone alters the normal flora of the colon leading to overgrowth of C. difficile.
  • Interaction with Calcium-Containing Products (See contraindications)
  • Hypersensitivity:

[edit] INTERACTIONS

  • Interaction with Calcium-Containing Products: ceftriaxone for injection and IV calcium-containing solutions should not be mixed or co-administered. Diluents containing calcium, such as Ringer’s solution or Hartmann’s solution should not be used.

Ceftriaxone is also contraindicated in newborns receiving concurrent administration of calcium-containing solutions or products due to risk of fatal precipitation in lungs and kidneys.

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category B (US). Ceftriaxone should be used during pregnancy only if clearly needed.
  • Nursing Mothers: Low concentrations of ceftriaxone are excreted in human milk. Caution should be exercised when ceftriaxone for injection is administered to a nursing woman.

[edit] SIDE EFFECTS

Common side effects include local irritation, pain, induration and tenderness at the injections site, rash (1.7%), and diarrhea (2.7%).

  • Hypoprothrombinaemia leading to an increased physiological risk for bleeding is a rare adverse effect to Ceftriaxone
  • Ceftriaxone therapy in children is linked to renal stones and pediatric acute renal failure (PARF). Predominant symptoms included sudden-onset anuria for at least 24 hours, flank pain, excessive crying, and/or vomiting. Early diagnosis and prompt pharmacological therapy are important in relieving the condition. Retrograde ureteral catheterization is an effective treatment of those who fail to respond to pharmacotherapy.
  • Ceftriaxone may precipitate in bile, causing biliary sludge and gallstones. The condition appears to be transient and reversible upon discontinuation of the drug.
  • Ceftriaxone may cause allergic reactions similar to those caused by penicillin. Due to the 3-8% cross allergenicity with penicillins, caution should be used in those with a history of severe allergies to penicillin.

[edit] RELATED LINKS

ß-Lactams: Mechanisms of Action and Resistance

[edit] BIBLIOGRAPHY

[edit] REFERENCES