Ceftriaxone
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
- 250mg IM x 1
- Give with doxycycline
Epididymitis
- 250mg IM x 1
- Give with doxycycline
Surgical Prophylaxis
- 1g IV x 1
- Give 0.5-2h preop
Chancroid
- 250mg IM x 1
- Give with doxycycline
Typhoid Fever
- 60mg/kg IV q24h x 2wk
- Max: 4g/24h
Pediatric Dosing
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