Dosage & Administration
Ceftriaxone can be administered either intravenously or intramuscularly. When reconstituted for intramuscular or intravenous injection, the white to yellowish-orange crystalline powder gives a pale yellow to amber solution.
Adults: The usual adult daily dose is 1-2 g once daily, (or twice daily in equally divided doses) depending on the type and severity of infection. The daily dose may be increased, but should not exceed 4 g. For preoperative use (surgical prophylaxis), a single dose of 1 gm administered intravenously 0.5-2 hours before surgery is recommended.
In elderly patients:
- Usual dose: The dosages do not require modification provided that renal and hepatic functions are satisfactory. In patients with impaired renal function, there is no need to reduce the dosage of Ceftriaxone provided liver function is intact. In patients with liver damage, there is no need for the dosage to be reduced provided renal function is intact.
- Gonorrhea: For the treatment of gonorrhea (penicillinase producing and non-penicillinase producing strains), a single intramuscular dose of 250 mg is recommended.
Children under 12 years:
- Usual dose: The recommended total daily dose is 50 to 75 mg/kg once daily (or twice daily in equally divided doses).
- In severe infections, up to 80 mg/kg body weight daily may be given. The total daily dose should not exceed 2 gm.
- In the treatment of meningitis, the initial dose of 100 mg/kg body weight (not to exceed 4 gm daily) once daily (or twice daily in equally divided doses), is recommended. As soon as the causative organism has been identified and its sensitivity, the doses can be reduced accordingly. The usual duration of therapy in meningitis is 7 to 14 days.
Ceftriaxone is generally well tolerated. A few side-effects such as
- Gastrointestinal effects include diarrhea, nausea and vomiting, stomatitis and glossitis
- Cutaneous reactions include rash, pruritus, urticaria, edema & erythema multiforme
- Hematological reactions include eosinophilia, thrombocytosis, leukopenia, and neutropenia
- Hepatic reactions include elevations of SGOT or SGPT, bilirubinemia
- CNS reactions include headache, hyperactivity, nervousness, sleep disturbances, confusion, hypertonia, and dizziness were reported. Local phlebitis occurs rarely following intravenous administration but can be minimized by slow injections over 2-4 minutes.