Ceftriaxone - instructions for use, reviews, analogs and formulations (powder for injection) of a drug for the treatment of infections in adults, children and pregnancy. How to grow a medicine for intramuscular and intravenous injections

In this article, you can read the instructions for using the drug Ceftriaxone. Comments from visitors to the site - consumers of this medication, as well as opinions of specialists on the use of Ceftriaxone in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Ceftriaxone in the presence of existing structural analogues.Use for the treatment of infectious diseases of bacterial nature (peritonitis, sepsis, pneumonia, pyelonephritis and others) in adults, children, as well as during pregnancy and lactation. We will tell you how to dilute ceftriaxone with Lidocaine and water for injections.

Ceftriaxone - 3-generation cephalosporin antibiotic of a broad spectrum of action. It acts bactericidal, inhibiting the synthesis of the cell wall of microorganisms. Resistant to beta-lactamases of most gram-positive and gram-negative bacteria.

It is active against gram-positive aerobic bacteria, gram-negative aerobic bacteria and anaerobic bacteria.

Has in vitro activity against most strains of the following microorganisms, although the clinical significance of this is unknown: Citrobacter diversus, Citrobacter freundii, Providencia spp. (including Providencia rettgeri), Salmonella spp. (including Salmonella typhi), Shigella spp., Streptococcus agalactiae, Bacteroides bivius, Bacteroides melaninogenicus.

Methicillin-resistant staphylococci are resistant to cephalosporins, incl. to ceftriaxone. Many strains of streptococcus group D and enterococci (including Enterococcus faecalis) are also resistant to ceftriaxone.

Pharmacokinetics

After an / m introduction, ceftriaxone is quickly and completely absorbed into the systemic circulation.It penetrates well into the tissues and body fluids: respiratory tract, bones, joints, urinary tract, skin, subcutaneous fat and abdominal cavity organs. When inflammation of the meningeal membranes well penetrates into the cerebrospinal fluid. Bioavailability of ceftriaxone with a / m introduction is 100%. In adult patients, within 48 hours, 50-60% of the drug is excreted by the kidneys unchanged, 40-50% is excreted with bile into the intestine, where it is biotransformed into an inactive metabolite.

Pharmacokinetics in special clinical cases

In newborn infants, about 70% of the drug is excreted by the kidneys.

Indications

Bacterial infections caused by susceptible microorganisms:

• infections of the abdominal cavity (peritonitis, inflammatory diseases of the digestive tract, bile duct, including cholangitis, empyema of the gallbladder);
• diseases of the upper and lower respiratory tract (including pneumonia, lung abscess, pleural empyema);
• infection of bones and joints;
• infections of the skin and soft tissues;
• urinary tract infections (including pyelonephritis);
• bacterial meningitis;
• endocarditis;
• sepsis;
• gonorrhea;
• syphilis;
• chancroid;
• Lyme disease (borreliosis);
• typhoid fever;
• salmonellosis and salmonella;
• infected wounds and burns.

Prevention of postoperative infection.

Infectious diseases in persons with weakened immunity.

Forms of release

Powder for solution for intravenous and intramuscular use 0.5 g, 1 g, 2 g.

Instructions for use and dosage

The drug is injected in / m and / in (jet or drip).

For adults and children over 12 years of age, the dose is 1-2 g once a day or 0.5-1 g every 12 hours. The maximum daily dose is 4 g.

For newborns (up to the age of 2 weeks), the dose is 20-50 mg / kg per day

For infants and children under 12 years of age, the daily dose is 20-80 mg / kg. In children with a body weight of 50 kg or more, doses for adults are used.

A dose of more than 50 mg / kg of body weight should be given as an IV infusion for 30 minutes. The length of the course of treatment depends on the nature and severity of the disease.

In bacterial meningitis in infants and young children, the dose is 100 mg / kg 1 time a day maximum daily dose - 4, the duration of therapy depends on the type of agent and may be from 4 days in meningitis caused by Neisseria meningitidis, 10-14 days with meningitis caused by sensitive strains of Enterobacteriaceae.

For treatment of gonorrhea, the dose is 250 mg IM once.

For the prevention of postoperative infectious complications, single-dose 1-2 g (depending on the degree of danger of infection) is administered 30-90 minutes before the operation begins. In operations on the colon and rectum, additional administration of a drug from the 5-nitroimidazole group is recommended.

For children with skin and soft tissue infection, the drug is prescribed in a daily dose of 50-75 mg / kg body weight 1 time / or 25-37.5 mg / kg every 12 hours, but not more than 2 grams per day. In severe infections of other locations - in a dose of 25-37.5 mg / kg every 12 hours, but not more than 2 grams per day.

With an average otitis, the drug is given in / m at a dose of 50 mg / kg body weight, but not more than 1 g.

In patients with impaired renal function, dose adjustment is required only for severe renal insufficiency (CC less than 10 ml / min), in which case the daily dose of ceftriaxone should not exceed 2 g.

Rules for the preparation and injection of injection solutions (how to dilute the drug)

Injection solutions should be prepared immediately before use.

To prepare a solution for intravenous injections, 500 mg of the drug is dissolved in 2 ml, and 1 g of the drug - in 3.5 ml of a 1% solution of lidocaine. It is recommended to inject no more than 1 g into one gluteus muscle.

Breeding for intramuscular use can also be done with water for injection. The effect is the same, but there will be a more painful introduction.

To prepare a solution for IV injection 500 mg of the drug is dissolved in 5 ml, and 1 g of the drug - in 10 ml of sterile water for injection. Injection solution is administered iv slowly for 2-4 minutes.

To prepare a solution for intravenous infusions, 2 g of the drug is dissolved in 40 ml of one of the following solutions that do not contain calcium: 0.9% sodium chloride solution, 5-10% Dextrose (glucose) solution, 5% levulose solution. The drug in a dose of 50 mg / kg or more should be injected / in a drip, for 30 minutes.

Freshly prepared ceftriaxone solutions are physically and chemically stable for 6 hours at room temperature.

Side effect

• headache, dizziness
• oliguria, impaired renal function
• glucosuria
• hematuria
• hypercreatinemia
• increase in urea
• nausea, vomiting
• taste disorder
• flatulence
• stomatitis, glossitis
• diarrhea
• dysbiosis
• abdominal pain
• anemia, leukopenia, leukocytosis, lymphopenia, neutropenia, granulocytopenia, thrombocytopenia,
• nasal bleeding
• urticaria, rash, itching
• anaphylactic shock
• bronchospasm.

Local reactions: with intravenous injection - phlebitis, tenderness along the vein; with the / m introduction - soreness in the injection site.

Contraindications

• hypersensitivity to the components of the drug;
• increased sensitivity to other cephalosporins, penicillins, carbapenems.

Application in pregnancy and lactation

The use of the drug in pregnancy is possible only if the intended benefit to the mother exceeds the potential risk for the fetus (in this case, it is usually not advised to use the drug because of possible complications of pregnancy and fetal disorders). If it is necessary to use the drug during lactation, breastfeeding should be stopped.

special instructions

When using the drug should take into account the risk of anaphylactic shock and the need for appropriate emergency therapy.

When combined with severe renal failure and severe hepatic insufficiency in patients on hemodialysis, the concentration of the drug in plasma should be regularly determined.

With long-term treatment, it is necessary to regularly monitor the picture of peripheral blood, indicators of the functional state of the liver and kidneys.

In rare cases with ultrasound of the gallbladder, blackouts are observed, which disappear after the cessation of treatment. Even if this phenomenon is accompanied by pain in the right hypochondrium, it is recommended continuation of Ceftriaxone therapy and symptomatic treatment.

Elderly and debilitated patients may require the appointment of vitamin K.

During treatment, alcohol is contraindicated, because Disulfiramoid-like effects are possible (facial hyperemia, abdominal and stomach cramps, nausea, vomiting, headache, decreased blood pressure, tachycardia, dyspnea).

Drug Interactions

Ceftriaxone and aminoglycosides have a synergistic effect on many Gram-negative bacteria.

When combined with NSAIDs and other antiplatelet agents, the risk of bleeding increases.

With simultaneous use with "loop" diuretics and other nephrotoxic drugs, the risk of nephrotoxic action increases.

The drug is not compatible with ethanol (alcohol).

Pharmaceutical interaction

Pharmaceutically incompatible with solutions containing other antibiotics.

Analogues of the drug Ceftriaxone

Structural analogs for the active substance:

• Azaran;
• Axon;
• Betasporin;
• Biotrakson;
• Lendacin;
• Lifaxon;
• Longacef;
• Megion;
• Medaxone;
• Movigip;
• Oframax;
• Rocefin;
• Steritsef;
• Tertsef;
• Torocephus;
• Triacsone;
• Forcef;
• Chizon;
• Cefaxon;
• Cefatrine;
• Cefogram;
• Cephson;
• Ceftriabal;
• Ceftriaxone-AKOS;
• Ceftriaxone-Vial;
• Ceftriaxone-CMP;
• Ceftriaxone sodium salt;
• Ceftriaxone Elf.

How to Breed Ceftriaxone (Memo)

 

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