Ceftriaxone

Question 1

Ceftriaxone Mechanism of Action

Answer 1

• Ceftriaxone is a cephalosporin antibiotic with broad activity against gram-negative and gram-positive bacteria. It inhibits production of the bacterial cell wall, causing bacteria to die.

Question 2

Ceftriaxone Indications

Answer 2

Suspected meningococcal septicaemia
Under consult - if patient is known to have allergy to Amoxiclav
Under consult - Unable to get IV access for amoxiclav

Question 3

Ceftriaxone Contraindications

Answer 3

Anaphylaxis to cephalosporins.

Question 4

Ceftriaxone Cautions

Answer 4

None

Question 5

Ceftriaxone Use in pregnancy/breastfeeding

Answer 5

Safe and should be administered if indicated.

Question 6

Ceftriaxone Dose

Answer 6

2 g IV for an adult.
• 2 g IM for an adult if IV access cannot be immediately obtained.
• See the paediatric drug dose tables for a child.

Question 7

Ceftriaxone IV Administration

Answer 7

a) Add approximately 4 ml of 0.9% sodium chloride to a 2 g ampoule and
shake until dissolved.
b) Draw up the ampoule and dilute to a total of 10 ml.
c) Discard unrequired volume before administration for a child.
d) Administer IV over 1-2 minutes, preferably into a running line.

Question 8

Ceftriaxone IM Administration

Answer 8

a) Add 4 ml of 0.9% sodium chloride to a 2 g ampoule and shake until
dissolved.
b) Draw up the ampoule using two syringes with approximately half in each.
The total volume will be 5 ml.
c) Discard unrequired volume before administration for a child.
d) Administer one syringe into each lateral thigh. If this site is not suitable, use
each lateral upper arm.

Question 9

Ceftriaxone Common adverse effects

Answer 9

None

Question 10

Ceftriaxone Usual onset of effect

Answer 10

30-60 minutes

Question 11

Ceftriaxone Usual duration of effect

Answer 11

24 hours

Question 12

Ceftriaxone Preparation

Answer 12

2g as powder

Question 13

Ceftriaxone Pharmacokinetics

Answer 13

• 50% is excreted in urine and 50% in bile.
• Neither renal impairment nor hepatic impairment alter the initial (loading)
dose.

Question 14

Ceftriaxone Common interactions

Answer 14

None

Question 15

Ceftriaxone Additional Information

Answer 15

As meningococcal bacteria die they release endotoxins. The body’s immune response to endotoxins can cause profound worsening of shock following antibiotic administration. Be prepared to treat this with 0.9% sodium chloride IV, and metaraminol or adrenaline IV. It is rare for significant amounts of
endotoxins to be released from other bacteria.