Ceftriaxone is a broad-spectrum β-lactam antibiotic that belongs to the third generation of cephalosporins. This medication is primarily used to treat various infections caused by susceptible bacteria, with its antibacterial mechanism based on inhibiting bacterial cell wall synthesis, exhibiting extensive antibacterial activity against both Gram-positive and Gram-negative bacteria.
This drug is commonly used for the treatment of severe infections such as pneumonia, urinary tract infections, intra-abdominal infections, and meningitis. Due to its longer half-life, it is usually administered once daily, making it suitable for clinical scenarios that require rapid onset and prolonged control of infections.
The generic name of this medication is Ceftriaxone, and common brand names in Taiwan and Hong Kong include Rocephin. Different countries or regions may have other trade names, but the main active ingredient is ceftriaxone sodium.
The pharmaceutical form includes sterile powder for injection, which must be administered by healthcare professionals via intravenous or intramuscular injection; it should not be taken orally. Generic drugs and brand-name drugs are bioequivalent in terms of chemical composition and efficacy.
Ceftriaxone belongs to the third generation of cephalosporin antibiotics within the β-lactam class, characterized by its potent antibacterial action against Gram-negative bacteria, while also demonstrating better penetration against certain resistant strains (such as those producing β-lactamase). The sulfur atom in its chemical structure contributes to its relatively low nephrotoxicity.
This classification differs from first and second-generation cephalosporins primarily in its broad coverage against Enterobacteriaceae, while still retaining antibacterial activity against certain Gram-positive bacteria, making it suitable for the treatment of multiple pathogens.
The main indications for ceftriaxone include bacterial pneumonia, urinary tract infections (including complicated urinary tract infections), intra-abdominal infections (such as peritonitis), bone and joint infections, and skin and soft tissue infections. This medication is also commonly used as a first-line treatment for meningitis (including infections caused by Neisseria meningitidis).
In certain situations, this drug may be used for infection prevention, such as before and after surgery. Physicians may adjust its use based on the results of susceptibility testing, especially for patients suspected of having infections caused by resistant strains.
Contraindications: This drug is contraindicated in individuals known to be allergic to cephalosporins or penicillins. Those with a history of anaphylactic shock are absolutely prohibited from using it, and allergy testing should be conducted prior to use.
Pregnant and breastfeeding women should use this medication only after a risk assessment by a physician. Reports have indicated that this drug may cause neonatal jaundice or adverse reactions in the skeletal system, so strict monitoring is required for newborns.
Patients with severe renal impairment may require dosage adjustments, as the drug is primarily metabolized by the kidneys. Concurrent use of diuretics may increase the risk of kidney stones, necessitating monitoring of blood calcium and urine pH levels.
While alcohol does not directly cause a disulfiram-like reaction, it may exacerbate dehydration. Excessive alcohol consumption should be avoided during the treatment period.
This medication is to be administered only by healthcare professionals via intravenous or intramuscular injection and should not be taken orally. The common adult dosage is 1-2 grams every 24 hours, which may be increased to 4 grams daily for severe infections, with specific dosages adjusted based on the severity of the infection and the patient's weight.
The injection form must strictly follow aseptic procedures, and it should be used immediately after dissolution or stored as directed by the manufacturer. The site for intramuscular injection should be rotated to avoid repeated injections in the same area, which can lead to tissue damage.
If a scheduled injection time is missed, it should be administered immediately and the timing for the next dose adjusted. However, if the next dose is less than 6 hours away, the missed dose should be skipped. Doubling the dose to make up for a missed dose is not recommended.
If the patient discovers a missed dose, they should immediately contact the healthcare facility to reschedule the injection and should not adjust the dosing frequency on their own to avoid overdose.
Overdose may lead to severe liver dysfunction or central nervous system depression, and immediate medical attention should be sought for supportive treatment. Emergency measures include gastric lavage, hemodialysis (if renal function is normal), and monitoring of liver and kidney function indices.
If symptoms of anaphylactic shock occur, epinephrine and antihistamines should be administered immediately, and airway patency should be maintained. Overdose patients should be hospitalized for observation for at least 24 hours.
If mild redness or a lump occurs after injection, applying ice may help relieve it, and observation should be made for any worsening. If accompanied by severe pain, pus formation, or fever, the medication should be stopped immediately and medical attention sought, as this may indicate infection or an allergic reaction. It is generally advised to avoid massaging the area within 24 hours after injection.
Should I stop the medication if a rash appears during ceftriaxone use?If the rash is accompanied by fever, difficulty breathing, or facial swelling, the medication should be stopped immediately and medical attention sought, as this may indicate a severe allergic reaction. If the rash appears alone and is mild, contact a physician to assess whether medication adjustment is necessary. Patients at risk for allergies should inform their physician in advance.
Does using ceftriaxone concurrently with pain relievers (such as ibuprofen) have any effects?Co-administration with non-steroidal anti-inflammatory pain relievers (such as ibuprofen) may increase the burden on the kidneys, especially for those who are dehydrated or have renal impairment. Physicians will weigh the risks and benefits based on the patient's condition and may adjust the dosage or recommend alternative pain relief methods if necessary.
Should I avoid calcium supplements while taking ceftriaxone?Intravenous ceftriaxone mixed with calcium-containing fluids may form crystals, and oral calcium tablets or supplements should be taken at least 2 hours apart from the medication. Calcium from regular dietary sources (such as milk and cheese) usually does not need to be avoided, but large doses of calcium supplements should be discussed with a physician.
Can ceftriaxone be used during pregnancy or breastfeeding?Ceftriaxone is classified as a category B pregnancy drug, and it may be used if necessary after evaluation by a physician, but it should be avoided in individuals allergic to cephalosporins. A small amount of the drug may be secreted into breast milk during breastfeeding, and the risks to the infant should be assessed before deciding whether to continue breastfeeding. Pregnant or breastfeeding women must inform their physician before using this medication.
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