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{{drugbox |
__NOTOC__
|width=300
{{Ceftriaxone}}
|IUPAC_name = (6''R'',7''R'',''Z'')-7-(2-(2-aminothiazol-4-yl)-<br />2-(methoxyimino)acetamido)-3-((6-hydroxy-2-methyl-5-oxo-<br />2,5-dihydro-1,2,4-triazin-3-ylthio)methyl)-8-oxo-5-thia-<br />1-aza-bicyclo[4.2.0]oct-2-ene-2-carboxylic acid
{{CMG}};{{AE}}{{AK}}
|CAS_number = 63527-52-6
| ATC_prefix=J01
| ATC_suffix=DD01
| PubChem=456256
| DrugBank=APRD00395
| C = 18 | H = 18 | N = 8 | O = 7 | S = 3
|molecular_weight = 554.58 [[Gram|g]]/[[Mole (unit)|mol]]
|bioavailability = n/a
|metabolism = Negligible
|elimination_half-life = 5.8–8.7 hours
|excretion = 33–67% [[Kidney|renal]], 35–45% [[biliary]]
|pregnancy_AU = B1
|pregnancy_US = B
|legal_AU = S4
|routes_of_administration = [[Intravenous therapy|Intravenous]], [[Intramuscular injection|intramuscular]]
}}
{{SI}}
{{CMG}}
 
 


==Overview==
==Overview==
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'''Ceftriaxone''' ([[International Nonproprietary Name|INN]]) ([[International Phonetic Alphabet|IPA]]: {{IPA|[kɛfˈtraɪækson, sɛf-]}}) is a third-generation [[cephalosporin]] [[antibiotic]].  Like other third-generation cephalosporins, it has broad spectrum activity against [[Gram positive]] and [[Gram negative]] [[bacteria]]. In most cases, it is considered to be equivalent to [[cefotaxime]] in terms of safety and efficacy. '''Ceftriaxone sodium''' is marketed by [[Hoffman-La Roche]] under the [[trade name]] '''Rocephin'''.
'''Ceftriaxone''' ([[International Nonproprietary Name|INN]]) ([[International Phonetic Alphabet|IPA]]: {{IPA|[kɛfˈtraɪækson, sɛf-]}}) is a third-generation [[cephalosporin]] [[antibiotic]].  Like other third-generation cephalosporins, it has broad spectrum activity against [[Gram positive]] and [[Gram negative]] [[bacteria]]. In most cases, it is considered to be equivalent to [[cefotaxime]] in terms of safety and efficacy. '''Ceftriaxone sodium''' is marketed by [[Hoffman-La Roche]] under the [[trade name]] '''Rocephin'''.


== Clinical use ==
==Category==
{{main|Cephalosporin}}
[[Cephalosporins]],third generation.
 
Ceftriaxone is often used (in combination, but not direct, with [[macrolide]] and/or [[aminoglycoside]] antibiotics) for the treatment of community-acquired [[pneumonia]]. It is also a choice drug for treatment of [[bacterial meningitis]]. In pediatrics, it is commonly used in febrile infants between 4 and 8 weeks of age who are admitted to the hospital to exclude [[sepsis]]. It has also been used in the treatment of [[Lyme disease]] and [[gonorrhea]].
 
The usual starting dose is 1 gram IV daily although dosage may be adjusted for body mass in younger patients. Doses range from 1–2 grams IV or IM every 12–24 hours, depending on the type and severity or the infection, up to 4 grams daily. For gonorrhoea the usual adult dose is a single intramuscular injection of 125 mg.  Patients treated for gonorrhoea are usually also treated for [[chlamydia]], often with [[azithromycin]]. The injection is unusually painful and therefore administered with [[lidocaine]] as a local anesthetic.  However, individuals who are allergic to lidocaine can expect approximately 1 hour of pain, similar to being forcefully kicked or punched in the  site of injection (usually the buttocks).  It is not a stinging or burning pain, and it is very intense for about 20 minutes, diminishing over 60 to 180 minutes.  Residual discomfort can last 24 hours.
 
Ceftriaxone is contraindicated in patients with known hypersensitivity to cephalosporins, [[penicillin]]s and/or [[carbapenem]]s.
 
Long term use of ceftriaxone through intravenous route can cause overgrowth of organisms on the surface of the tongue.  Monitoring tongue and oral cavity is recommended.
 
==[http://www.fda.gov/medwatch/safety/2009/safety09.htm#Ceftriaxone Warnings]==
 
FDA notified healthcare professionals of an update to a previous alert that addresses the interaction of ceftriaxone with calcium-containing products, based on previously reported fatal cases in neonates.
 
At the request of FDA, the manufacturer of ceftriaxone (Roche) conducted two in vitro studies to assess the potential for precipitation of ceftriaxone-calcium when ceftriaxone and calcium-containing products are mixed in vials and in infusion lines.
 
These two in vitro studies were conducted in neonatal and adult plasma to assess the potential for precipitation of ceftriaxone-calcium using varying ceftriaxone and calcium concentrations, including concentrations in excess of those achieved in vivo.
 
Based on the results from these studies, FDA now recommends that ceftriaxone and calcium-containing products may be used concomitantly in patients >28 days of age, using the precautionary recommendations noted because the risk of precipitation is low in this population.
 
'''FDA had previously recommended, but no longer recommends, that in all age groups ceftriaxone and calcium-containing products should not be administered within 48 hours of one another.'''
 
== Chemistry ==
 
Ceftriaxone is a yellowish-orange crystalline powder which is readily-soluble in water, sparingly soluble in methanol and very slightly soluble in ethanol. The [[pH]] of a 1% aqueous solution is approximately 6.7.
 
The ''syn''-configuration of the methoxyimino moiety confers stability to β-lactamase enzymes produced by many [[Gram-negative]] bacteria. Such stability to β-lactamases increases the activity of ceftriaxone against otherwise resistant Gram-negative bacteria. In place of the easily [[hydrolysis|hydrolysed]] [[acetyl]] group of cefotaxime, ceftriaxone has a metabolically-stable thiotriazinedione moiety.
 
== External links ==
*[http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202119.html MedlinePlus Drug Information: Cephalosporins (systemic)] – information from USP DI Advice for the Patient
*[http://www.rocheusa.com/products/rocephin/ Rocephin U.S. Prescribing Information]
 


{{CephalosporinAntiBiotics}}
==US Brand Names==
CEFTRIAXONE<sup>®</sup> ,ROCEPHIN<sup>®</sup>


==FDA Package Insert==
'''[[Ceftriaxone description|Description]]'''
'''| [[Ceftriaxone clinical pharmacology|Clinical Pharmacology]]'''
'''| [[Ceftriaxone microbiology|Microbiology]]'''
'''| [[Ceftriaxone indications and usage|Indications and Usage]]'''
'''| [[Ceftriaxone contraindications|Contraindications]]'''
'''| [[Ceftriaxone warnings|Warnings]]'''
'''| [[Ceftriaxone precautions|Precautions]]'''
'''| [[Ceftriaxone adverse reactions|Adverse Reactions]]'''
'''| [[Ceftriaxone overdosage|Overdosage]]'''
'''| [[Ceftriaxone clinical studies|Clinical Studies]]'''
'''| [[Ceftriaxone dosage and administration|Dosage and Administration]]'''
'''| [[Ceftriaxone compatibility reconstitution and stability|Compatibility, Reconstitution, and Stability]]'''
'''| [[Ceftriaxone directions for use|Directions For Use]]'''
'''| [[Ceftriaxone how supplied|How Supplied]]'''
'''| [[Ceftriaxone labels and packages|Labels and Packages]]'''


[[Category:Cephalosporin antibiotics]]
[[Category:Triazines]]
[[Category:Thiazoles]]


[[de:Ceftriaxon]]
==References==
[[fr:Ceftriaxone]]
{{Reflist|2}}
[[hu:Ceftriaxon]]
http://www.accessdata.fda.gov/drugsatfda_docs/label/2005/050796lbl.pdf
[[pl:Ceftriakson]]
[[Category:Antibiotics]]
[[pt:Ceftriaxona]]
[[Category:Wikinfect]]
[[th:เซฟไตรอะโซน]]
[[zh:頭孢曲松]]
{{WikiDoc Help Menu}}
{{WS}}

Revision as of 16:00, 31 December 2013

Ceftriaxone
CEFTRIAXONE®,ROCEPHIN® FDA Package Insert
Description
Clinical Pharmacology
Microbiology
Indications and Usage
Contraindications
Warnings and Precautions
Adverse Reactions
Overdosage
Dosage and Administration
Clinical Studies
Compatibility and Stability
How Supplied
Labels and Packages

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Abdurahman Khalil, M.D. [2]

Overview

Ceftriaxone (INN) (IPA: Template:IPA) is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram positive and Gram negative bacteria. In most cases, it is considered to be equivalent to cefotaxime in terms of safety and efficacy. Ceftriaxone sodium is marketed by Hoffman-La Roche under the trade name Rocephin.

Category

Cephalosporins,third generation.

US Brand Names

CEFTRIAXONE® ,ROCEPHIN®

FDA Package Insert

Description | Clinical Pharmacology | Microbiology | Indications and Usage | Contraindications | Warnings | Precautions | Adverse Reactions | Overdosage | Clinical Studies | Dosage and Administration | Compatibility, Reconstitution, and Stability | Directions For Use | How Supplied | Labels and Packages


References

http://www.accessdata.fda.gov/drugsatfda_docs/label/2005/050796lbl.pdf

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