Ceftriaxone is a broad-spectrum β-lactam antibiotic belonging to the third generation of cephalosporins. This medication is primarily used to treat various infections caused by susceptible bacteria. Its antibacterial mechanism involves inhibiting bacterial cell wall synthesis, exhibiting broad activity against both Gram-positive and Gram-negative bacteria.
It is commonly used for severe infections such as pneumonia, urinary tract infections, intra-abdominal infections, and meningitis. Due to its longer half-life, it is typically administered once daily, making it suitable for clinical scenarios requiring rapid onset and prolonged infection control.
The generic name of this drug is Ceftriaxone. In Taiwan and Hong Kong, the common brand name is Rocephin. Different countries or regions may have other brand names, but the main active ingredient remains ceftriaxone sodium.
The drug formulation includes sterile powder for injection, which must be administered via intravenous or intramuscular injection by healthcare professionals. It is not for oral use. Generic and brand-name drugs are bioequivalent in chemical composition and efficacy.
Ceftriaxone belongs to the third generation of β-lactam antibiotics within the cephalosporin class. This classification is characterized by potent activity against Gram-negative bacteria and better penetration into certain resistant strains (such as β-lactamase-producing bacteria). The sulfur atom in its chemical structure makes it relatively less nephrotoxic.
Compared to first- and second-generation cephalosporins, ceftriaxone has a broader coverage of Enterobacteriaceae and retains activity against some Gram-positive bacteria, making it suitable for treating multiple pathogens.
Ceftriaxone is mainly indicated for bacterial pneumonia, urinary tract infections (including complicated UTIs), intra-abdominal infections (such as peritonitis), osteoarticular infections, and skin and soft tissue infections. It is also often the first choice for treating meningitis, including meningococcal meningitis.
In certain cases, this drug can be used for prophylaxis against infections, such as before and after surgery. Physicians may adjust usage based on sensitivity test results, especially for infections caused by suspected resistant strains.
Serious side effects requiring immediate medical attention:
Contraindications: Do not use in individuals allergic to cephalosporins or penicillins. Absolute contraindication in patients with a history of anaphylactic reactions. Allergic testing is recommended before use.
Pregnant and breastfeeding women should use this medication only after risk assessment by a healthcare provider. Reports suggest that this drug may cause neonatal jaundice or skeletal abnormalities, so neonatal use requires strict monitoring.
Patients with severe renal impairment should have dose adjustments, as the drug is primarily excreted via the kidneys. Concurrent use of diuretics may increase the risk of kidney stones; calcium levels and urine pH should be monitored.
Concurrent use with alcohol does not produce a disulfiram-like reaction but may exacerbate dehydration. Alcohol consumption should be avoided during treatment.
This medication should only be administered via intravenous or intramuscular injection by healthcare professionals. It is not for self-administration. The typical adult dose is 1-2 grams every 24 hours; in severe infections, it can be increased to 4 grams daily. The exact dose depends on the severity of the infection and patient weight.
Injection should be performed under strict aseptic conditions. After reconstitution, use immediately or store according to manufacturer instructions. Rotate injection sites for intramuscular administration to prevent tissue damage.
If a scheduled injection is missed, it should be administered as soon as possible, and the next dose time should be adjusted accordingly. If less than 6 hours remain before the next dose, skip the missed dose. Do not double the dose to compensate for missed injections.
If the patient notices a missed dose, they should contact their healthcare provider immediately to reschedule. Do not adjust the dosing schedule independently to avoid overdose.
Overdose may lead to severe liver dysfunction or central nervous system depression. Immediate medical attention is required for supportive treatment. Emergency measures include gastric lavage, hemodialysis (if renal function is normal), and monitoring of liver and kidney function tests.
In cases of anaphylactic shock or other severe allergic reactions, epinephrine and antihistamines should be administered immediately, and airway patency must be maintained. Hospitalization and observation for at least 24 hours are recommended for overdose patients.
What should I do if I experience redness or swelling at the injection site after ceftriaxone injection?
Mild redness or swelling can be alleviated with ice packs and observed for worsening. If accompanied by severe pain, pus, or fever, stop the medication and seek medical attention. These may indicate infection or allergic reaction. It is generally recommended to avoid massaging the area within 24 hours after injection.
If a rash occurs while using ceftriaxone, should I stop the medication?
If the rash is accompanied by fever, difficulty breathing, or facial swelling, stop the medication immediately and seek medical attention, as this may indicate a severe allergic reaction. If the rash is mild and isolated, consult a doctor for assessment and possible adjustment of therapy. Patients with allergy risk should inform their healthcare provider beforehand.
Does concurrent use of ceftriaxone and pain relievers (such as ibuprofen) affect treatment?
Using non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen together with ceftriaxone may increase renal burden, especially in dehydrated or renal-impaired patients. The doctor will weigh the benefits and risks and may adjust doses or recommend alternative pain management methods.
Should I avoid calcium supplements while taking ceftriaxone?
Intravenous mixing of ceftriaxone with calcium-containing fluids can form crystals. Oral calcium tablets or supplements should be taken at least 2 hours apart from ceftriaxone. Dietary calcium from milk or cheese generally does not need to be avoided, but excessive calcium supplementation should be discussed with a healthcare provider.
Can pregnant or breastfeeding women use ceftriaxone?
Ceftriaxone is classified as pregnancy category B. It can be used during pregnancy if necessary, after evaluation by a healthcare provider, but should be avoided in individuals allergic to cephalosporins. During breastfeeding, small amounts of the drug may pass into breast milk; the risks to the infant should be assessed before continuing breastfeeding. Pregnant or breastfeeding women must inform their doctor before use.
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