Exephin

Indications

Ceftriaxone is an antibiotic injection used for serious bacterial infections, including:

• Pneumonia and other chest infections
• Meningitis (infection of the lining of the brain)
• Typhoid (enteric fever)
• Kidney and urinary tract infections
• Gonorrhoea
• Infections of the bones, joints, skin, soft tissues and abdomen
• Blood infection (sepsis)
• Prevention of infection before some operations

It does not work against viral infections such as colds or flu.

How It Works

Ceftriaxone belongs to the cephalosporin group of antibiotics. It stops bacteria from building their protective cell wall, so the bacteria burst and die. It stays in the body for a long time, so it is usually given once a day.

Dosage and Administration

Ceftriaxone is given by a doctor or nurse, either into a vein (injection or drip) or deep into a muscle. For adults, it is commonly 1 to 2 g once a day, and up to 4 g a day in severe infections such as meningitis. Children's doses are worked out by body weight. The exact dose and length of treatment depend on the infection and are given as prescribed. Complete the full course even if you feel better.

Interactions

• Calcium-containing drips (such as Ringer's lactate or calcium gluconate) must not be mixed with ceftriaxone or given through the same line at the same time. In newborn babies, the two must not be given together at all.
• It may increase the effect of Warfarin, so blood clotting tests may be needed.
• When Lidocaine is used to make the muscle injection less painful, that mixture must never be given into a vein.

Contraindications

• Allergy to ceftriaxone or any other cephalosporin.
• A past severe allergic reaction (anaphylaxis) to penicillin or other beta-lactam antibiotics.
• Premature babies, and newborns with jaundice or who need calcium given into a vein.

Side Effects

Common: pain or hardness at the injection site, diarrhoea, nausea, rash, changes in liver blood tests and blood counts, and thrush (fungal infection) of the mouth or genitals. It can sometimes form a sludge in the gallbladder that usually clears after treatment stops.

Get urgent medical help for signs of a severe allergic reaction (swelling of the face or throat, difficulty breathing, fainting), severe or bloody diarrhoea during or after treatment, a widespread rash with blisters or peeling skin, yellow eyes or skin, severe pain in the upper right abdomen, unusual bruising or bleeding, or passing much less urine.

Pregnancy and Lactation

Ceftriaxone is generally considered acceptable in pregnancy when clearly needed, and the doctor will weigh the benefits. Small amounts pass into breast milk; breastfeeding can usually continue, but watch the baby for diarrhoea, rash or thrush.

Precautions and Warnings

• Tell the doctor about any allergy to penicillin or other antibiotics before treatment.
• Extra care is needed when both the liver and kidneys are not working well.
• Long courses may need blood tests.
• It can affect some laboratory tests, such as the Coombs test and some urine sugar tests.

Overdose

Overdose is unlikely because it is given by health staff. Too much may cause nausea, vomiting and diarrhoea. Treatment is supportive in hospital; dialysis does not remove it well.

Therapeutic Class

Third-generation cephalosporin antibiotic.

Storage

Store the unopened vial below 30°C in a dry place, away from light and out of the reach of children. Once mixed, the solution should be used promptly, following the product leaflet.