Ceftriaxone

Ceftriaxone (Rocephin) , is a third-generation cephalosporin antibiotic used for the treatment of a number of bacterial infections.

Drug Class

It is a third-generation cephalosporin antibiotic.

Mechanism of Action

Ceftriaxone inhibits the cell wall synthesis of bacteria by binding to penicillin-binding proteins (PBPs). This destroys the integrity of the bacterial cell wall, leading to cell death.

Uses of Ceftriaxone

Infections of the Respiratory Tract

Pneumonia (community-acquired and hospital-acquired)
Bronchitis exacerbations

Infections of the Central Nervous System

Meningitis caused by susceptible organisms like Neisseria meningitidis and Streptococcus pneumoniae

Infections of the Urinary Tract

Complicated UTIs, including pyelonephritis

Septicemia

Treatment of bacteremia and septic shock caused by susceptible pathogens

Gonorrhea

Uncomplicated gonorrhea (Neisseria gonorrhoeae)

Perioperative Prophylaxis

Prevention of infections following surgery, especially in high-risk procedures

Side Effects of Ceftriaxone

Gastrointestinal: Diarrhea, nausea, vomiting, abdominal pain
Allergic Reactions: Rash, anaphylaxis, urticaria
Hematologic: Hemolytic anemia, eosinophilia, thrombocytopenia
Hepatic: Elevated liver enzymes (AST/ALT)
Renal: Renal dysfunction (rare)
Injection Site Reactions: Pain, swelling, or phlebitis at the injection site
Other: Clostridium difficile-associated diarrhea

Contraindications of Ceftriaxone

Hypersensitivity to ceftriaxone or other cephalosporins
Neonates with hyperbilirubinemia or those receiving calcium-containing intravenous solutions
Severe renal or hepatic impairment (without dose adjustment)
Preterm neonates with jaundice or hypoalbuminemia

Drug-Drug Interactions

it may interact with following medications.

Aminoglycosides (e.g., gentamicin)
Anticoagulants (e.g., warfarin)
Probenecid
Calcium-containing IV solutions (incompatible in neonates)

Drug-Food Interactions

Alcohol (may cause a disulfiram-like reaction)
Food (may delay absorption slightly but does not significantly affect efficacy)

Popular Brand Names of Ceftriaxone

Brand Name	Strength	Formulation	Manufacturer
Rocephin	1g, 2g	IV/IM Injection	Roche
Ceftriaxone Actavis	1g, 2g	IV/IM Injection	Actavis
Ceftriaxone Sandoz	1g, 2g	IV/IM Injection	Sandoz
Ceftriaxone Teva	1g, 2g	IV/IM Injection	Teva Pharmaceuticals
Cefaxone	1g, 2g	IV/IM Injection	Glenmark

Conclusion

Ceftriaxone is a highly effective broad-spectrum antibiotic commonly used for treating serious bacterial infections. While it is generally well-tolerated, its use should be carefully monitored due to potential side effects and contraindications, particularly in neonates and those with severe renal or hepatic conditions. Proper administration and dose adjustments are key to maximizing its therapeutic benefit.

References

Lexicomp. (2024). https://www.uptodate.com
Mayo Clinic. (2024). Ceftriaxone (Rocephin). Drugs and Supplements.
FDA. (2024). Ceftriaxone Injection. FDA Drug Database.
National Institutes of Health (NIH). (2024). Ceftriaxone. DailyMed.
World Health Organization (WHO). (2024). Ceftriaxone for Injection. WHO Essential Medicines List.