The drug is used intramuscularly and intravenously.
For adults and for children over 12 years old
The average daily dose is 1-2 g of ceftriaxone once a day or 0.5-1 g every 12 hours.
In severe cases or in cases of infections caused by moderately sensitive pathogens, the daily dose may be increased to 4 g.
For newborns
When applied once a day, the following scheme is recommended:
For newborns (up to 2 weeks of age): 20-50 mg / kg of body weight per day (a dose of 50 mg / kg of body weight is not recommended because of the immature enzyme system of newborns).
When determining the dose, there is no need to distinguish between full and premature babies.
For infants and children under 12 years of age
Newborns, infants and young children (from 15 days to 12 years): 20-80 mg / kg body weight once a day. Children with a body weight of 50 kg and above should adhere to the dosage for adults. A dose of more than 50 mg / kg body weight should be given as an intravenous infusion, for at least 30 minutes.
In the treatment of acute otitis media in children, a single IV IM is recommended in a dose of 50 mg / kg (but not more than 1 g).
Duration of therapy
Depends on the course of the disease.
The drug should be continued for at least 48-72 hours after the normalization of body temperature and confirmation of eradication of the pathogen.
The course of treatment for infections caused by Streptococcus pyogenes, must be at least 10 days.
Meningitis
In bacterial meningitis in newborns and in children, the initial dose is 100 mg / kg of body weight once a day (maximum 4 g).Once it was possible to isolate the pathogenic microorganism and determine its sensitivity, the dose should be reduced accordingly. The best results were achieved with the following periods of therapy:
| Causative agent | Duration of therapy |
| Neisseria meningitidis | 4 the day |
| Haemophilus influenzae | 6 days |
| Streptococcus pneumoniae | 7 days |
Gonorrhea
For the treatment of gonorrhea caused by both generative and non-penicillinase-resistant strains, the recommended dose is 250 mg once intramuscularly.
Preventive maintenance in pre- and postoperative period
Before being infected or Presumably infected with surgical interventions to prevent postoperative infections, depending on the risk of infection, a single administration of ceftriaxone in a dose of 1-2 g is recommended 30-90 minutes before surgery.
In operations on the colon and rectum, additional administration of a drug from the 5-nitroimidazole group is recommended.
Lack of kidney and liver function In patients with impaired renal function, under the condition of normal liver function, a dose of ceftriaxone is not necessary to reduce.
Only if the kidneys are deficient in the preterminal stage (creatinine clearance below 10 ml / min) it is necessary that the daily dose of ceftriaxone does not exceed 2 g.In patients with impaired liver function, if the function of the kidneys is preserved, the dose of ceftriaxone is also not necessary. In patients with renal-hepatic insufficiency, the daily dose should not exceed 2 g without determining the concentration of ceftriaxone in the blood plasma. Patients on hemodialysis, additional administration of the drug after dialysis is not required. It should, however, control the concentration of ceftriaxone in the plasma, since its excretion in such patients can be slowed down (dose adjustment may be required). Solvents containing calcium (for example, Ringer's solution or Hartmann's solution) should not be used to dilute ceftriaxone in a vial or for further dilution ceftriaxone in a vial for intravenous administration because of the possibility of precipitation. The formation of calcium ceftriaxone precipitate is also possible with the mixing of ceftriaxone with calcium-containing solutions in one infusion system. For this reason ceftriaxone and calcium-containing solutions can not be mixed or administered simultaneously.
Intramuscular injection
For intramuscular injection, 1 g of the drug should be diluted in 3.5 ml of a 1% solution of lidocaine for injection and inserted deep into the gluteal muscle, it is recommended to inject no more than 1 g of the drug into one buttock. A solution of lidocaine can never be administered intravenously!
Intravenous administration
For intravenous administration, 1 g of the drug should be diluted in 10 ml of sterile water for injection and administered intravenously slowly for 2-4 minutes.
Intravenous infusion
Duration of intravenous infusion for at least 30 minutes. For intravenous infusion, 2 g of powder should be diluted in approximately 40 ml of a calcium-free solution, for example: 0.9% solution of sodium chloride, at 5% solution of dextrose, at 10% solution of dextrose, 5% solution of fructose.