Ceftriaxone - instructions for use, dose, side effects, contraindications

Has bactericidal action due to inhibition of bacterial cell wall synthesis. Violates the synthesis of the biopolymer peptidoglikana - the main component of the cell wall of bacteria. It inhibits the peptidoglycan transpeptidase, inhibits the activity of the endogenous inhibitor, which leads to activation of murein hydrolase, which cleaves peptidoglycan. Effective against fissile bacteria, in the walls of which the synthesis of peptidoglycan occurs.

Active with respect to many gram-positive and gram-negative aerobic bacteria and anaerobes. Effective at respect Bacteroides bivius, Bacteroides melaninogenicus, Streptococcus agalactiae, Citrobacter diversus, Citrobacter freundii, Shigella spp., Providencia spp. It affects multidrug resistant strains tolerant to penicillins and cephalosporins of the first generations and aminoglycosides.

Pharmacokinetics:

After intramuscular injection, the maximum concentration in the blood plasma is achieved in 2-3 hours, after intravenous administration - after 30 minutes and stored for 24 hours. The connection with plasma proteins is 85-95%.

Penetrates into all organs and tissues. It enters the cerebrospinal fluid with meningitis.

Not exposed to metabolism. Do not cumulate. Penetrates through the placental barrier, is found in breast milk.

The half-life is 8 hours. Elimination by the kidneys.

Indications:

It is used to treat infections caused by microorganisms that are sensitive to ceftriaxone: urinary tract, lower respiratory tract, pneumonia, septicemia, gonococcal infection, primary syphilis and soft chancre, infections of the abdominal cavity organs, skin, soft tissues and joints, bacterial meningitis and other serious infections. It is used to prevent purulent-septic complications in surgical intervention and in persons with weakened immunity.

ICD-10

I.A00-A09.A01 Typhus and paratyphoid

I.A00-A09.A02 Other salmonella infections

I.A00-A09.A03.0 Shigellosis caused by Shigella dysenteriae

I.A30-A49.A39 Meningococcal infection

I.A30-A49.A40 Streptococcal septicemia

I.A30-A49.A41 Other septicemia

VI.G00-G09.G00 Bacterial meningitis, not elsewhere classified

X.J10-J18.J15 Bacterial pneumonia, not elsewhere classified

X.J85-J86.J85 Abscess of the lung and mediastinum

X.J85-J86.J86 Pythothrace

XI.K65-K67.K65.0 Acute peritonitis

XI.K80-K87.K81.1 Chronic cholecystitis

XI.K80-K87.K81.0 Acute cholecystitis

XI.K80-K87.K83.0 Cholangitis

XII.L00-L08.L01 Impetigo

XII.L00-L08.L02 Abscess of skin, boil and carbuncle

XII.L00-L08.L03 Phlegmon

XII.L00-L08.L08.0 Pyoderma

XIII.M00-M03.M00 Pyogenic arthritis

XIII.M86-M90.M86 Osteomyelitis

XIV.N10-N16.N11 Chronic tubulointerstitial nephritis

XIV.N10-N16.N10 Acute tubulointerstitial nephritis

XIV.N30-N39.N30 Cystitis

XIV.N30-N39.N34 Urethritis and urethral syndrome

XIV.N40-N51.N41 Inflammatory diseases of the prostate

XIV.N70-N77.N70 Salpingitis and oophoritis

XIV.N70-N77.N71.0 Acute inflammatory disease of the uterus

XIV.N70-N77.N72 Inflammatory disease of the cervix

XIV.N70-N77.N73.0 Acute parametritis and pelvic cellulite

XIX.T79.T79.3 Post-traumatic wound infection, not elsewhere classified

XXI.Z20-Z29.Z29.2 Another type of preventive chemotherapy

Contraindications:

Individual intolerance to β-lactam antibiotics: penicillins and cephalosporins.

Carefully:

Imbalance of electrolytes or fluids, severe liver damage, colitis in history.

Pregnancy and lactation:

Recommendations for FDA - Category B. It is used with caution during pregnancy in those cases where the intended benefit exceeds the risk to the fetus. It is not used for lactation - it penetrates into breast milk.

Dosing and Administration:

Use in children

Intramuscularly and intravenously:

newborns up to 2 weeks: 20-50 mg / kg once a day;

From the 3rd week to 12 years: 20-80 mg / kg once a day.

Adult doses are used for children weighing more than 50 kg.

Adults

Intravenous and intramuscular, 1-2 g every 24 hours or 0.5-1.0 g every 12 hours. Preventive maintenance of postoperative infections - 1 g once for 0,5-2 hours before surgery.

The highest daily dose: 4 g.

The highest single dose: 2 g.

Side effects:

Central and peripheral nervous system: rarely - convulsions.

Hemopoietic system: thrombocytopenia, eosinophilia, leukopenia, an increase in prothrombin idenes and coagulation time.

Digestive system: nausea, vomiting, diarrhea, increased activity of hepatic enzymes, hepatic or cholestatic jaundice, intestinal dysbacteriosis.

Dermatological reactions: local reactions - compaction at the injection site, candidiasis dermatitis, vulvovaginitis.

urinary system: rarely - the development of hypokalemia.

Allergic reactions.

Overdose:

Nausea, vomiting, diarrhea, neuromuscular excitability, convulsive attacks.

Treatment is symptomatic, hemodialysis.

Interaction:

Simultaneous application with probenecid slows the renal excretion of ceftriaxone.

"Loop diuretics" block tubular secretion ceftriaxone.

Special instructions:

Simultaneous use with ethanol can cause a disulfiram-like reaction.

During treatment, a false positive Coombs reaction and a false positive urine reaction to glucose are possible.

Instructions

Ceftriaxone (Ceftriaxonum)