Ceftriaxone

Definition
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Broad-spectrum cefalosporin of the 3rd generation.

Half-life
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6–9 h

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Dermatology

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Spectrum of action
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Aeromonas hydrophilia, Capnocytophaga spp., Borrelia burgdorferi, Citrobacter spp., Clostridium perfringens, Enterobacter spp., E. coli, Hafnia alvei, Haemophilus spp., Klebsiella spp., Moraxella spp., Morganella morganii, Neisseria spp, Pasteurella multocida, Peptostreptococcus spp., Plesiomonas shigelloides, Prevotella spp., Proteus spp., Providencia spp., Salmonella spp., Serratia spp., Shigella spp., Staphylococcus spp., Streptococcus spp., Treponema pallidum, Yersinia spp.

Indication
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Severe, life-threatening respiratory tract, urinary tract, skin, soft tissue, bone and joint infections. Therapy of acute neuroborreliosis, gonorrhoea, syphilis.

Dosage and method of use
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Once 1-2 g/day i.v. (max. 4 g/day).
Children: 20-80 mg/kg bw/day.
Lyme disease: once 2 g/day for 2-4 weeks.
Syphilis: 1 time 1 g/day i.v. over 10 days
Gonorrhoea: 1.0 g i.v./i.m. as ED. To the i.m. administration 1.0 g ceftriaxone powder is dissolved in 4 ml 1% lidocaine hydrochloride. Injection in 1 or 2 portions (right (left) deep intragluteal. Lidocaine must not be administered intravenously.

Preparations
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Rocephin, ceftriaxon-ratiopharm

Note(s)
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Little or no effectiveness against staphylococci
Ineffective against listeria (meningitis!)
For life-threatening infections combination therapy is possible (aminoglycoside, clindamycin, metronidazole)

Literature
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Li RC et al (2004) Protein binding and antimicrobial activity of ceftriaxone: comparative assessments by gradient plate technique and time-kill study. J Chemother 16: 524-549