Ceftriaxone

Question 1

Drug class

Answer 1

Antibiotic

Question 2

Pharmacology

Answer 2

A third generation cephalosporin antibiotic with bacterial action

Question 3

Metabolism

Answer 3

Excreted as a variety of active & inactive metabolites from the body through urine, bile & faeces

Question 4

Indications

Answer 4

Suspected meningococcal septicaemia

with a non-blanching petechial AND/OR purpuric rash

Question 5

Contraindications

Answer 5

• Allergy and/or adverse drug reaction to cephlosporin ABs
• Known immediate or severe hypersensitivity to penicillin or carbapenen based drugs
• Pt less than 1mo - consult required

Question 6

Precautions

Answer 6

Any allergy or hypersensitivity to penicillin or carbapenem (isolated minor rash does not contraindicate)

Question 7

Side effects

Answer 7

• Severe pain at the IM admin site

Question 8

Presentation

Onset

Duration

Answer 8

1g powder

Variable

Approx 1 day

Question 9

Routes of administration

Answer 9

IM / IV INF

Question 10

Adult Dosages

Answer 10

IM 
2g (2x 1g IM injections), single dose only
Reconstitute 2x vials each containing 1g with 2.4ml of water for injection or lidocaine in a 3ml syringe = 1g/3ml

IV INF
2g over 20mins, single dose only
Reconstitute 2g with 18.8ml of water for injection in a 30ml Springfusor = 2g/20ml & admin at rate of 60ml/hr over 20mins

Question 11

Paediatric dosages

Answer 11

! Consult for <1mo

IM
50mg/kg (rounded up to nearest 5kg), total max dose 1g, single dose only
Reconstitute 1g with 2.4ml water for injection or lidocaine. Use 3ml syringe

Weight / Dose / Volume 
≤ 5kg / 250mg / 0.75ml
>5-10kg / 500mg / 1.5ml
>10-15kg / 750mg / 2.25ml
>15kg / 1g / 3ml

**capped at 1g; all does >2ml to be admin by two separate injections

IV INF
>20kg (approx >4yrs), 50mg/kg (rounded to nearest 5kg), total max dose 2g, single dose only
Reconstitute 2g with 8.8ml water for injection in a 30ml Springfusor = 200mg/ml (2g/10ml) over 20ml @ rate of 60ml/hr

Weight / Dose / Volume 
>20-25kg / 1.25g / ~6.25ml
>25-30kg / 1.5g / 7.5ml
>30-35kg / 1.75mg / ~8.75ml
>35kg / 2g / 10ml