Tercef® is injected deep into the / m or IV / (drip, jet).
Tercef® can be used after the preparation of the solution according to the recommendations presented below.
The dose and method of administration should be determined depending on the severity and location of the infection, the sensitivity of the pathogen, as well as the age and condition of the patient.
In / in the injection should be administered for at least 2-4 minutes.A dose of more than 50 mg / kg of body weight should be slowly injected for at least 30 minutes. In / m administration, as a rule, is contraindicated in children up to 2 years (when used as a solvent lidocaine).
For the / m introduction, follow the instructions given below.
Adults and children over 12 years of age with a body weight >50 kg
The average daily dose is 1-2 g of ceftriaxone once a day (every 24 hours). In severe cases or infections, the causative agents of which have only moderate sensitivity to ceftriaxone, the daily dose can be increased to 4 g.
Newborns (up to 2 weeks)
20-50 mg / kg body weight IV once a day (with an interval of 24 hours). With heavy
the daily dose should not exceed 50 mg / kg.
For infants, see section Special instructions.
When determining the dose, no distinction should be made between full-term and
premature babies.
In newborns, the duration of IV infusion should be at least 60 minutes, in order
To prevent the displacement of bilirubin from serum albumin, thereby
reducing the risk of developing bilirubin encephalopathy.
Children (the first 15 days of life up to 12 years) with a body weight of <50 kg
20-80 mg / kg of body weight once a day (with an interval of 24 hours).
In severe infections, the daily dose should not exceed 80 mg / kg, except for the treatment of meningitis.
Children with a body weight of 50 kg or more are prescribed doses intended for adults.
Elderly patients
Older patients are not required to adjust the dose.
Special recommendations for dosing
Meningitis
Treatment begins with the introduction of 100 mg / kg once a day, the daily dose should not exceed 4 g. After identifying the pathogen and determining its sensitivity, the dose can be reduced accordingly. The best results for meningococcal meningitis were achieved with a duration of treatment for 4 days, with meningitis caused by Haemophilus influenzae - 6 days, Streptococcus pneumoniae - 7 days.
For newborns (up to 2 weeks), the dose should not exceed 50 mg / kg / day.
When Lyme disease Adults and children are prescribed in a dose of 50 mg / kg (maximum
daily dose - 2 g), once a day for 14 days.
When uncomplicated gonorrhea (caused by penicillinase-producing and penicillinase-forming strains), Tertsef® is administered once a day at a dose of 250 mg.
Prevention of postoperative infections
It should be used 1-2 g of the drug Tertsef® once for 30-90 minutes before the beginning of surgical intervention in / m or / in.In operations on the colon and rectum, the simultaneous (but separate) administration of the Tertsef® preparation and one of the 5-nitroimidazoles, for example, ornidazole, was well established.
Renal insufficiency
In patients with impaired renal function there is no need to reduce the dose, if the function liver remains normal. Only in cases of severe renal failure, with creatinine clearance <10 ml / min, the daily dose should not exceed 2 g in adult patients.
Liver failure
In patients with hepatic dysfunction there is no need to reduce the dose, if the function kidneys remains normal.
When combination of severe renal and hepatic insufficiency should regularly monitor the concentration of ceftriaxone in the plasma and, if necessary, adjust its dose (see sections Special instructions and pharmacokinetics).
Hemodialysis or peritoneal dialysis
Because the ceftriaxone to a small extent dialyzed, patients on dialysis, additional administration of the drug after the dialysis session is not required, however, it is necessary to monitor the concentration of ceftriaxone in the serum for possible dose adjustment, since the rate of excretion of the drug in these patients may be reduced.
In patients on long-term outpatient peritoneal dialysis (CAPD), ceftriaxone can be administered intravenously or in the case of development of infections associated with the administration of CAPD, ceftriaxone can be added directly to the dialysate (for example, 1 -2 g of ceftriaxone is added to the first portions of the dialysate on the day of treatment).
Duration of treatment
The duration of treatment with Tertsef® depends on the course of the disease, it should be continued for at least 2-3 days after the disappearance of the clinical symptoms of the disease or after a negative result of the microbiological examination. Recommendations for dosing should be observed for specific indications.
Method of solution preparation
Despite the fact that the prepared solutions retain their physical and chemical stability for 24 hours at a temperature of 2-8 ° C, it is better to use freshly prepared solutions immediately after preparation. Do not use calcium-containing solutions (such as Ringer and Hartmann) to dilute the preparation because of the possibility of precipitation.The formation of calcium ceftriaxone precipitate is also possible by mixing ceftriaxone with calcium-containing solutions in one infusion line.
For this reason ceftriaxone and calcium-containing solutions should not be mixed or administered simultaneously (see section Special instructions).
If there is no history of allergic reactions, make a scarification skin test with the drug solution. In the presence of allergic reactions in the anamnesis, first make a skin test and, if it has a negative result, proceed to the scarification sample. The result of the samples is read after 30 minutes. Intramuscular injections of Tertsef® without lidocaine are painful. When using lidocaine as a solvent, it is necessary to make a test for hypersensitivity to it.
Do not administer intravenous solutions of Tertsef® with lidocaine! After a / m injection, it is recommended to always pull the syringe plunger (no blood should appear) to make sure that the blood vessel is not damaged.
Cooking method
For intravenous injection 1 g or 2 g of Tertsef® is dissolved in 3.6 ml or 7.2 ml of a 1% solution of lidocaine (concentration of ceftriaxone 250 mg / ml), respectively. Beforehand, the sensitivity of the patient to lidocaine should be determined.In / m injections of solutions in water for injections are painful. If necessary, solutions with higher dilution may be administered. The injection is injected deep into the gluteus muscle. It is recommended to inject no more than 1 g of the drug into one buttock. Solutions of the drug Tercef® with lidocaine, prepared for the / m introduction, do not inject IV!
For direct intravenous injection 1 g or 2 g of Tertsef® is dissolved in 9.6 ml or 19.2 ml of sterile water for injection (ceftriaxone concentration 100 mg / ml), respectively. The duration of the injection is 2-4 minutes.
For short-term intravenous infusion 1 g and 2 g of Tertsef® are also dissolved for direct intravenous injection and diluted to a concentration of ceftriaxone 10 mg / ml in 90 ml and 180 ml of solvent, respectively. The following solvents are used for the preparation of infusion: water for injection, 0.9% sodium chloride solution, 5%, 10% dextrose (glucose) solution, 5% levulose solution. The duration of the infusion is 30 minutes.
Solutions of Tercef® should not be mixed or added to solutions containing other antibiotics or other solvents, with the exception of those listed above, because of possible incompatibility.