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
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 from 15 days and children under 12 years of age
The daily dose is 20-80 mg / kg of 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.
Duration of therapy
Depends on the nature of the severity of the disease. As always with antibiotic therapy, the drug should be continued for at least 48 to 72 hours after the normalization of body temperature and confirmation of eradication of the pathogen.
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 days |
| Haemophilus influenzae | 6 days |
| Streptococcus pneumoniae | 7 days |
| Sensitive Enterobacteriacease | 10-14 days |
Gonorrhea
For the treatment of gonorrhea caused by both generative and non-penicillinase-resistant strains, the recommended dose is 250 mg once intramuscularly.
Borreliosis Lyme
50 mg / kg (the highest daily dose of 2 g) for adults and children over 12 years, 1 time per day for 14 days.
Prevention in the pre- and postoperative period
Depending on the danger of infection, one-time administration of ceftriaxone in a dose of 1-2 g is recommended 30-90 minutes prior to surgery. For operations on the colon and rectum, additional administration of the drug from the 5-nitroimidazoles 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 maintained, the dose of ceftriaxone should not be reduced.
In cases of simultaneous presence of severe pathology of the liver and kidneys, the concentration of ceftriaxone in serum should be monitored regularly. In patients undergoing hemodialysis, the dose of the drug after this procedure is not necessary to change. It should, however, monitor the concentration of ceftriaxone in the serum for the possibility of dose adjustment. Since the rate of excretion in these patients may be reduced.
Intramuscular injection
For intramuscular injection, 1 g of the drug is dissolved in 3.5 ml of a 1% solution of lidocaine and injected deep into the relatively large muscle (gluteal), it is recommended to inject no more than 1 g of the drug into one muscle. Trial aspiration avoids overdose. A solution of lidocaine can never be administered intravenously!
Intravenous administration
For intravenous injection, 1 g of the drug is dissolved in 10 ml of water for injection, administered intravenously slowly for 2-4 minutes.
Intravenous infusion
For intravenous infusion 2 g of the powder should be dissolved in approximately 40 ml of a solution that does not contain calcium, for example: in a 0.9% solution of sodium chloride, in a 5% dextrose solution, in a 10% solution of dextrose, 5% solution of fructose. Duration of intravenous infusion is at least 30 minutes.