Ceftriaxone: Difference between revisions
| Line 50: | Line 50: | ||
===General (<7 Days Old)=== | ===General (<7 Days Old)=== | ||
*50 mg/kg IM/IV q24h | *50 mg/kg IM/IV q24h | ||
*First | *First Dose: 50 mg/kg IM/IV x 1 | ||
===General (7 Days - 1 Month)=== | ===General (7 Days - 1 Month)=== | ||
*<2000g | *<2000g | ||
**50 mg/kg IM/IV q24h | **50 mg/kg IM/IV q24h | ||
**First | **First Dose: 50 mg/kg IM/IV x 1 | ||
*>2000g | *>2000g | ||
**50-75 mg/kg IM/IV q24h | **50-75 mg/kg IM/IV q24h | ||
**First | **First Dose: 50-75 mg/kg IM/IV x 1 | ||
===General (>1 Month - Adult)=== | ===General (>1 Month - Adult)=== | ||
*50-100 mg/kg IM/IV divided q12-24h | *50-100 mg/kg IM/IV divided q12-24h | ||
*First | *First Dose: 50-100 mg/kg IM/IV x 1 | ||
*Max: 4g/24h | *Max: 4g/24h | ||
===Acute [[Otitis Media]] (2 Months - 12 Years)=== | |||
*50 mg/kg IM/IV x 1 | |||
*Give 50 mg/kg IM/IV q24h x 3 days for recurrent infection | |||
*Max 1g/dose | |||
===Bacterial [[Meningitis]]=== | |||
*80-100 mg/kg IV divided q12-24h x 7-21 days | |||
*First Dose: 100mg/kg IV x 1 | |||
*Max: 4g/24h | |||
===[[Pneumonia]], Community-Acquired (>3 Months)=== | |||
*50-100 mg/kg/day IM/IV divided q12-24h x 10 days | |||
*First Dose: | |||
*Max: 2g/day | |||
*Info: May switch to PO when possible to complete course | |||
==Contraindications== | ==Contraindications== | ||
Revision as of 21:04, 27 February 2014
General
- Type: 3rd generation cephalosporins
- Dosage Forms: IM, IV
- Common Trade Names: Rocephin
Adult Dosing
General
- 1-2g IM/IV q24h
- First ED Dose: 1g IM/IV x 1
- Max: 4g/24h
Bacterial Meningitis
- 4g IV divided q12-24h x 7-21 days
- First ED Dose: 2g IM/IV x 1
Gonococcal
- Uncomplicated, initial: 250mg IM x 1
- Also treat for chlamydia regardless of test results
- Uncomplicated, recurrent of persistent: 500-1000mg IM x 1
- Disseminated: 1g IM/IV q24h
- May switch to cefixime PO after 24-48h if clinical improvement
- Conjunctivitis: 1g IM x 1
- Prophylaxis (sexual assault victims)
- 250mg IM x 1
PID
- 250mg IM x 1
- Use with doxycycline +/- metronidazole
Sinusitis, Severe
- 1-2g IV q12-24h x 7-10 days
Endocarditis
- 1g IM/IV x 1
- 30-60 min before procedure
Proctitis, Epididymitis, Chancroid
- 250mg IM x 1
- Give with doxycycline
Surgical Prophylaxis
- 1g IV x 1
- Give 0.5-2h preop
Typhoid Fever
- 60mg/kg IV q24h x 2wk
- Max: 4g/24h
Pediatric Dosing
General (<7 Days Old)
- 50 mg/kg IM/IV q24h
- First Dose: 50 mg/kg IM/IV x 1
General (7 Days - 1 Month)
- <2000g
- 50 mg/kg IM/IV q24h
- First Dose: 50 mg/kg IM/IV x 1
- >2000g
- 50-75 mg/kg IM/IV q24h
- First Dose: 50-75 mg/kg IM/IV x 1
General (>1 Month - Adult)
- 50-100 mg/kg IM/IV divided q12-24h
- First Dose: 50-100 mg/kg IM/IV x 1
- Max: 4g/24h
Acute Otitis Media (2 Months - 12 Years)
- 50 mg/kg IM/IV x 1
- Give 50 mg/kg IM/IV q24h x 3 days for recurrent infection
- Max 1g/dose
Bacterial Meningitis
- 80-100 mg/kg IV divided q12-24h x 7-21 days
- First Dose: 100mg/kg IV x 1
- Max: 4g/24h
Pneumonia, Community-Acquired (>3 Months)
- 50-100 mg/kg/day IM/IV divided q12-24h x 10 days
- First Dose:
- Max: 2g/day
- Info: May switch to PO when possible to complete course
Contraindications
- Allergy to class/drug
Adverse Reactions
Pharmacology
- Half-life: 5.8-8.7h, 15h (CrCl 5-15)
- Metabolism: CYP450
- Excretion: Primarily urine
- Mechanism of Action: bactericidal; inhibits cell wall synthesis
Pregnancy/Lactation
- Pregnancy: B
- Lactation: Probably safe