CEFRAKEN INJECTION

Indications

• Bacterial infections of the lower respiratory tract
• Skin and soft tissue infections
• Bone and joint infections
• Intra-abdominal infections
• Meningitis
• Sepsis
• Urinary tract infections
• Pelvic inflammatory disease

Dosage

Children: Refer to the BNF for Children for specific dosing recommendations tailored to pediatric patients.

Adults: Refer to the BNF for specific dosing recommendations based on the type and severity of infection.

Mechanism of action

Ceftriaxone works by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, which interferes with the final transpeptidation step of peptidoglycan synthesis, leading to cell lysis and death. This action is effective against rapidly dividing bacteria.

Pharmacodynamics

Ceftriaxone exhibits time-dependent bactericidal activity. Its effectiveness is influenced by the duration that plasma concentrations exceed the minimum inhibitory concentration (MIC) of the target organism. The drug has a broad spectrum of activity, which includes many strains of Streptococcus pneumoniae, Escherichia coli, and Neisseria gonorrhoeae, among others.

Pharmacokinetics

Ceftriaxone is administered via the intravenous or intramuscular route. It achieves peak plasma concentrations within 2 hours of administration. The drug has a large volume of distribution, indicating extensive tissue penetration. Ceftriaxone is primarily eliminated by the kidneys, although a significant portion is excreted unchanged in urine. Its half-life is approximately 6 to 8 hours in adults, allowing for once-daily dosing in many cases.

Contra-indications

• Hypersensitivity to ceftriaxone or any other cephalosporin antibiotics
• Newborns with hyperbilirubinemia
• Concurrent use with calcium-containing solutions in neonates

Adverse effects

• Diarrhea
• Rash
• Nausea
• Vomiting
• Allergic reactions
• Thrombocytopenia
• Neutropenia
• Elevated liver enzymes
• Severe skin reactions (e.g., Stevens-Johnson syndrome)

Interactions

• Increased risk of nephrotoxicity when used with aminoglycosides
• May interfere with the effectiveness of oral contraceptives
• Anticoagulants may increase the risk of bleeding

Precautions

• Use caution in patients with a history of penicillin allergy
• Monitor renal function in patients with renal impairment
• Use with caution in patients with gastrointestinal disease, particularly colitis
• Adjustment of dose may be needed in severe hepatic impairment

Pregnancy

Ceftriaxone is classified as Category B. Animal studies have not shown any harm, but there are no well-controlled studies in pregnant women. Use only if clearly needed.

Breast-feeding

Ceftriaxone is excreted in breast milk in small amounts. Caution is advised when administering to nursing mothers.

Storage

Store at room temperature, away from light. Reconstituted solutions should be used promptly and can be stored in the refrigerator for a limited time.

Formulations

• Injectable solution (IV or IM)
• Powder for reconstitution