Dosing
CrCl > 80: 1 - 2 g iv q 12 - 24 h.
CrCl 80-50: 1 - 2 g iv q 12 - 24 h.
CrCl 50-10: 1 - 2 g iv q 12 - 24 h.
CrCl < 10: 1 - 2 g iv q 12 - 24 h
Hemodialysis:
Peritoneal dialysis:
Important side effects
Cholestatic hepatitis and the formation of ceftriaxone gall stones, the worlds most expensive. Usually seen at high doses. Also, much more rarely, renal stones (PubMed).
Important drug interactions
Increases cyclosporine levels.
QT prolongation when combined with lansoprazole.
When combined with intravenous calcium in neonates it can lead to death. Importance of this reaction in adults is not known as of 10/3/7, but it always show up as an annoying EMR warning.
Rants and Screeds
I wonder which is more expensive: ceftriaxone gallstones or crixivan kidney stones?
Pearls
Treatment of choice
Use for
Abdominal hysterectomy, Arthritis, Bronchitis, Brucella infections, Cellulitis, Brucella, Cystic fibrosis, Endocarditis, endocervical Gonorrhea, Epididymitis, Escherichia coli infections, Gonorrhea, Haemophilus influenzae infections and nasopharyngeal carriers, intra-abdominal infections, Intra abdominal infections, Lyme Disease, Meningitis, Moraxella catarrhalis infections, Neisseria meningitidis pharyngeal carriers, Neutropenic fever, Osteomyelitis, Otitis media, Peritonitis, PID, Pneumonia, Proctitis, Proteus, Providencia stuartii infections, Relapsing Fever, Salmonella infections, Sepsis, Serratia infections, sexual assault, Shigella infections, shunt infections, surgical prophylaxis, syphilis, Typhoid fever, UTI, vaginal hysterectomy.
Don't use for
Pseudomonas and its ilk. S. aureus.
Class
Third generation cephalosporin.
Last Update: 08/26/19.