OFRAMAX INJECTION 1G

Indications

• Bacterial meningitis
• Pneumonia
• Skin and soft tissue infections
• Urinary tract infections
• Intra-abdominal infections
• Bone and joint infections
• Septicemia
• Pelvic inflammatory disease

Dosage

Children: Refer to the BNF for Children for specific dosing information.

Adults: Refer to the appropriate clinical guidelines or BNF for specific dosing information.

Mechanism of action

Ceftriaxone exerts its antibacterial effect by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, which leads to the disruption of cell wall integrity, causing cell lysis and death. This mechanism is primarily effective during the active growth phase of bacteria.

Pharmacodynamics

Ceftriaxone exhibits time-dependent killing, which means that its effectiveness is related to the duration of time that the drug concentration remains above the minimum inhibitory concentration (MIC) for the target organism. The drug demonstrates a broad spectrum of activity against many strains of bacteria, including Enterobacteriaceae, Streptococcus pneumoniae, and Neisseria gonorrhoeae, making it a versatile option in empirical therapy for serious infections.

Pharmacokinetics

Ceftriaxone is well absorbed after intramuscular injection and achieves high plasma concentrations. It has a large volume of distribution, which allows it to penetrate well into tissues and fluids, including the cerebrospinal fluid. The elimination half-life is approximately 6 to 9 hours, allowing for once or twice daily dosing. Ceftriaxone is primarily eliminated by the kidneys, with some elimination occurring via the biliary route. Its clearance may be reduced in patients with renal impairment.

Contra-indications

• Hypersensitivity to ceftriaxone or any component of the formulation
• History of severe allergic reactions to other beta-lactam antibiotics
• Neonates requiring treatment with calcium-containing solutions

Adverse effects

• Diarrhea
• Rash
• Nausea
• Vomiting
• Elevated liver enzymes
• Hypersensitivity reactions
• Thrombocytopenia
• Nephrotoxicity
• Seizures (rare)

Interactions

• Calcium-containing solutions (risk of precipitation in neonates)
• Probenecid (may increase ceftriaxone levels)
• Anticoagulants (increased risk of bleeding)
• Aminoglycosides (risk of nephrotoxicity)

Precautions

• Use with caution in patients with a history of gastrointestinal disease, particularly colitis
• Monitor renal function in patients with pre-existing renal impairment
• Caution in pregnant women, especially in the third trimester

Pregnancy

Ceftriaxone is classified as pregnancy category B. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Ceftriaxone is excreted in breast milk. Caution should be exercised when administering to nursing women.

Storage

Store at 20-25 degrees Celsius. Protect from light and moisture. Once reconstituted, it should be used promptly or stored as per manufacturer guidelines.

Formulations

• Powder for solution for injection
• Powder for solution for infusion