Overview
Ceftriaxone is a third-generation cephalosporin antibiotic with broad-spectrum activity against Gram-positive and Gram-negative bacteria. It is commonly used for serious infections including meningitis, pneumonia, and intra-abdominal infections. The drug is administered via intravenous or intramuscular injection and requires careful attention to calcium-containing solutions to avoid precipitation.
Mechanism of Action
Ceftriaxone is a bactericidal antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs). This disruption of peptidoglycan cross-linking leads to osmotic instability and cell lysis, particularly effective against rapidly dividing organisms.
Indications
- Bacterial meningitis
- Lower respiratory tract infections
- Skin and skin structure infections
- Urinary tract infections
- Intra-abdominal infections
- Bone and joint infections
- Gonorrhea
- Septicemia
- Prophylaxis in surgical procedures
Common Doses
- 250 mg
- 500 mg
- 1 g
- 2 g
Dosage
Typically administered as 1-2 grams once daily via IV or IM injection. Dosage adjustments required for renal impairment. Must not be mixed with calcium-containing IV solutions due to precipitation risk.
Contraindications
- Known hypersensitivity to ceftriaxone or other cephalosporins
- History of severe allergic reactions to penicillins
- Neonates receiving calcium-containing IV solutions
Side Effects
- Diarrhea
- Injection site reactions
- Rash
- Elevated liver enzymes
- Eosinophilia
- Thrombocytosis
- Pseudomembranous colitis
- Hypersensitivity reactions
- Renal impairment
Interactions
- Calcium-containing IV solutions (precipitation risk)
- Probenecid (may increase ceftriaxone concentrations)
- Warfarin (potential enhanced anticoagulant effect)
- Aminoglycosides (synergistic antibacterial effect)
Counseling Points
- Complete full course of therapy even if symptoms improve
- Report severe diarrhea, rash, or breathing difficulties immediately
- Inform healthcare provider of all medications being taken
- Avoid alcohol during treatment
- Notify provider if pregnant or breastfeeding