Your activity: 322 p.v.
your limit has been reached. plz Donate us to allow your ip full access, Email: sshnevis@outlook.com

Ceftriaxone: Pediatric drug information

Ceftriaxone: Pediatric drug information
(For additional information see "Ceftriaxone: Drug information" and see "Ceftriaxone: Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Therapeutic Category
  • Antibiotic, Cephalosporin (Third Generation)
Dosing: Neonatal

Note: Use alternative therapy if patient is receiving IV calcium in any form (including parenteral nutrition); administer cautiously to hyperbilirubinemic neonates, especially those born prematurely (Ref).

General dosing (Ref): Preterm and term neonates: IM, IV: 50 mg/kg/dose every 24 hours.

Gonococcal infections

Gonococcal infections (Ref): Note: Administer cautiously to hyperbilirubinemic neonates, especially those born prematurely; alternative agent may be necessary.

Prophylaxis, asymptomatic neonates born to mothers with gonococcal infection: IM, IV: 20 to 50 mg/kg as a single dose; maximum dose: 250 mg/dose.

Treatment:

Disseminated infection (including sepsis, arthritis, and meningitis) or scalp abscess: IM, IV: 25 to 50 mg/kg/dose every 24 hours. For sepsis, arthritis, or scalp abscess, treat for 7 days; for documented meningitis treat for 10 to 14 days.

Ophthalmia neonatorum: IM, IV: 25 to 50 mg/kg as a single dose; maximum dose: 250 mg/dose. Note: May also be used for prophylaxis if erythromycin ointment is not available.

Meningitis, nongonococcal

Meningitis, nongonococcal: Limited data available; optimal dose not established: Note: IDSA guidelines do not provide ceftriaxone dosing for neonates (Ref). Dosing based on an open-label prospective trial of 71 patients (age range: PNA 14 days to 15 years) which included 26 patients diagnosed with meningitis and a pharmacokinetic analysis of 20 neonates and infants (n=12 neonates; including 6 with PNA <14 days) with sepsis or meningitis; both trials reported adequate cerebrospinal fluid penetration and favorable response (Ref).

PNA <14 days: IV: 50 mg/kg/dose every 24 hours.

PNA ≥14 days: IV: 100 mg/kg for one dose, followed by 80 to 100 mg/kg/dose every 24 hours.

Syphilis, congenital

Syphilis, congenital (alternative agent for confirmed or highly probable congenital syphilis): Note: Only for use when aqueous and procaine penicillin are unavailable (eg, shortage) due to insufficient data for use; if used, close monitoring and follow-up in consultation with an expert are required (Ref).

IV: 50 to 75 mg/kg/dose every 24 hours; duration dependent on close clinical and serological follow-up (Ref).

Dosing: Pediatric

General dosing: Infants, Children, and Adolescents: IM, IV: 50 to 75 mg/kg/dose every 24 hours; maximum dose: 1,000 mg/dose; higher doses are recommended in certain infections (eg, endocarditis, meningitis) (Ref).

Chancroid

Chancroid: Infants, Children, and Adolescents: IM: 50 mg/kg as a single dose; maximum dose: 250 mg/dose (Ref).

Endocarditis, bacterial

Endocarditis, bacterial:

Prophylaxis before invasive dental or respiratory tract procedures (alternative agent for patients with nonsevere, non-IgE-mediated allergy to penicillin who cannot take oral therapy):

Note: Recommended only in patients who are at highest risk for infective endocarditis (IE) or adverse outcomes (eg, history of IE, prosthetic heart valves, or prosthetic material used to repair valves, unrepaired cyanotic congenital heart disease, repaired congenital heart disease with prosthetic material or device during first 6 months after procedure, repaired congenital heart disease with residual defects at the site or adjacent to site of prosthetic patch or device, heart transplant recipients with cardiac valvulopathy) (Ref).

Infants, Children, and Adolescents: IM, IV: 50 mg/kg 30 to 60 minutes prior to procedure; maximum dose: 1,000 mg/dose (Ref).

Treatment: Children and Adolescents: IV: 50 mg/kg/dose every 12 hours or 80 mg/kg/dose every 24 hours; maximum daily dose: 4,000 mg/day; daily doses over 2,000 mg should be divided into 2 doses. Treat for ≥4 weeks depending on pathogen and valve type; longer durations may be necessary; use in combination with other antibiotics depending on pathogen (Ref).

Epididymitis, acute; empiric treatment

Epididymitis, acute; empiric treatment: Adolescents: IM: 500 mg as a single dose; 1,000 mg is recommended for patients weighing ≥150 kg. Use as part of an appropriate combination regimen (Ref).

Gonococcal infections, treatment

Gonococcal infections, treatment:

Uncomplicated gonococcal infection (cervicitis, pharyngitis, proctitis, and urethritis): Note: For pharyngeal gonorrhea, a test-of-cure is recommended 7 to 14 days following treatment (Ref).

Infants and Children weighing ≤45 kg: IM, IV: 25 to 50 mg/kg as a single dose; maximum dose: 250 mg/dose (Ref).

Children weighing >45 kg and Adolescents: IM: 500 mg as a single dose; 1,000 mg is recommended for patients weighing ≥150 kg. If chlamydial infection has not been excluded, give as part of an appropriate combination regimen (Ref).

Disseminated gonococcal infection (arthritis or arthritis-dermatitis syndrome):

Infants and Children: IM, IV: 50 mg/kg/dose every 24 hours for 7 days; maximum dose: 2,000 mg/dose (Ref).

Adolescents: IM, IV: 1,000 mg every 24 hours; may switch to an oral agent (per susceptibility testing) 24 to 48 hours after clinical improvement and treat for a total of ≥7 days. If chlamydial infection has not been excluded, give as part of an appropriate combination regimen (Ref).

Gonococcal bacteremia:

Infants and Children weighing ≤45 kg: IM, IV: 50 mg/kg/dose every 24 hours for 7 days; maximum dose: 2,000 mg/dose (Ref).

Children weighing >45 kg and Adolescents: IM, IV: 1,000 mg every 24 hours for 7 days (Ref).

Gonococcal conjunctivitis: Adolescents: IM: 1,000 mg in a single dose. If chlamydial infection has not been excluded, give as part of an appropriate combination regimen (Ref).

Intra-abdominal infection, complicated

Intra-abdominal infection, complicated: Infants, Children, and Adolescents: IV: 50 to 100 mg/kg/day divided every 12 to 24 hours; maximum daily dose: 2,000 mg/day (Ref).

Lyme disease

Lyme disease (Borrelia spp. infection): Limited data available: Infants, Children, and Adolescents: IV: 50 to 75 mg/kg/dose every 24 hours; maximum dose: 2,000 mg/dose. Duration of therapy depends on clinical syndrome; treat meningitis, radiculopathy, or carditis for 14 to 21 days, and recurrent or refractory arthritis for 14 to 28 days depending on clinical response (Ref).

Meningitis, bacterial

Meningitis, bacterial: Note: Per the manufacturer's labeling, doses may be administered IM.

Community-acquired meningitis: Infants, Children, and Adolescents: IV: 80 to 100 mg/kg/day divided every 12 to 24 hours; maximum daily dose: 4,000 mg/day (Ref).

Health care-associated meningitis/ventriculitis: Infants, Children, and Adolescents: IV: 100 mg/kg/day divided every 12 to 24 hours; maximum daily dose: 4,000 mg/day (Ref).

Meningococcal disease, chemoprophylaxis for high-risk contacts

Meningococcal disease, chemoprophylaxis for high-risk contacts (following close exposure to patients with invasive meningococcal disease):

Infants, Children, and Adolescents <15 years: IM: 125 mg in a single dose (Ref).

Adolescents ≥15 years: IM: 250 mg in a single dose (Ref).

Otitis media, acute

Otitis media, acute:

Infants, Children, and Adolescents:

Initial treatment (alternative agent for patients who cannot tolerate oral therapy): IM, IV: 50 mg/kg/dose every 24 hours for 1 to 3 days; maximum dose: 1,000 mg/dose (Ref).

Failure of initial treatment or suspected/proven penicillin-resistant Streptococcus pneumoniae: IM, IV: 50 mg/kg/dose every 24 hours for 3 days; maximum dose: 1,000 mg/dose (Ref).

Peritonitis, prophylaxis for patients receiving peritoneal dialysis who require dental procedures

Peritonitis (peritoneal dialysis), prophylaxis for patients receiving peritoneal dialysis who require dental procedures: Infants, Children, and Adolescents: IM, IV: 50 mg/kg administered 30 to 60 minutes before dental procedure; maximum dose: 1,000 mg/dose (Ref).

Pneumonia, community-acquired

Pneumonia, community-acquired (CAP): Infants >3 months, Children, and Adolescents: IV: 50 to 100 mg/kg/day divided every 12 to 24 hours; maximum daily dose: 2,000 mg/day (Ref); higher maximum daily doses of 4,000 mg/day are recommended for HIV-exposed/-infected patients (Ref). Note: Use as part of appropriate combination therapy if methicillin-resistant Staphylococcus aureus (MRSA) or atypical pathogens are of concern. Use doses on the higher end of the range for penicillin-resistant S. pneumoniae (Ref).

Rhinosinusitis, acute bacterial

Rhinosinusitis, acute bacterial:

Ambulatory patients (alternative agent): Children and Adolescents: IM, IV: 50 mg/kg as a single dose; maximum dose: 1,000 mg/dose; use for patients who are unable to tolerate oral medication, or unlikely to be adherent to the initial doses of antibiotic (Ref).

Severe infection requiring hospitalization: Infants, Children, and Adolescents: IV: 25 mg/kg/dose every 12 hours for 10 to 14 days; maximum dose: 2,000 mg/dose (Ref).

Salmonella species infection, treatment

Salmonella species infection, treatment:

Nontyphoidal Salmonella infection (alternative agent): Note: Antibiotic treatment is typically not needed for uncomplicated nontyphoidal Salmonella infection; consider treating infants <3 months of age and persons with immunosuppression, chronic GI tract disease, and significant cardiac or joint disease (Ref).

Non-HIV-infected: Infants, Children, and Adolescents: IM, IV: 75 to 100 mg/kg/day divided every 12 to 24 hours; treat GI infections for 5 to 14 days (Ref); maximum dose: 2,000 mg/dose.

HIV-infected: Adolescents: IV: 1,000 mg every 24 hours for ≥7 to 14 days; bacteremia should be treated for ≥14 days (longer if bacteremia persists or infection is complicated); treat patients with CD4 counts <200 cells/mm3 for 2 to 6 weeks (Ref).

Typhoid fever (Salmonella typhi): Note: Reserve for patients who have failed oral therapy or who have severe disease, intestinal complications, or obtundation and cannot take oral medications (Ref).

Infants, Children, and Adolescents: IV: 75 to 80 mg/kg/dose every 24 hours for 5 to 14 days (Ref); maximum dose: 2,000 mg/dose (Ref).

Sexually transmitted infections, prophylaxis following sexual assault

Sexually transmitted infections, prophylaxis following sexual assault: Adolescents: IM: 500 mg as a single dose; 1,000 mg is recommended in patients weighing ≥150 kg. Use as part of an appropriate combination regimen (Ref).

Shigellosis

Shigellosis: Infants, Children, and Adolescents: IM, IV: 50 to 100 mg/kg/dose every 24 hours for 2 to 5 days; maximum dose: 2,000 mg/dose (Ref). Note: Mild infections typically do not require antibiotic treatment; antibiotics are recommended for patients with severe disease or immunosuppression (Ref).

Skin and soft tissue infection

Skin and soft tissue infection: Infants, Children, and Adolescents: IM, IV: 50 to 75 mg/kg/day in divided doses every 12 to 24 hours; maximum daily dose: 2,000 mg/day.

Surgical prophylaxis

Surgical prophylaxis: Children and Adolescents: IV: 50 to 75 mg/kg within 60 minutes prior to the procedure; maximum dose: 2,000 mg/dose (Ref).

Syphilis

Syphilis (alternative agent): Note: Not considered first-line therapy; use should be reserved for special circumstances with close monitoring and follow-up.

Congenital syphilis (Ref): Note: Only for use when aqueous and procaine penicillin are unavailable (eg, shortage) due to insufficient data for use; if used, close monitoring and follow-up in consultation with an expert are required (Ref).

Infants: IM, IV: 75 mg/kg/dose every 24 hours for 10 to 14 days; maximum dose: 2,000 mg/dose.

Children: IM, IV: 100 mg/kg/dose every 24 hours for 10 to 14 days; maximum dose: 2,000 mg/dose.

Acquired syphilis (nonpregnant patients with penicillin allergy):

Early syphilis (primary, secondary, and early-latent): Adolescents: IM, IV: 1,000 mg every 24 hours for 10 to 14 days; optimal dose and duration have not been defined (Ref). Note: If adherence or follow-up cannot be ensured, patients with penicillin allergy should be desensitized to penicillin (Ref).

Neurosyphilis: Adolescents: IM, IV: 1,000 to 2,000 mg every 24 hours for 10 to 14 days; patients infected with HIV should receive 2,000 mg once daily. Note: Patients with penicillin allergy should be desensitized to penicillin whenever possible (Ref).

Urinary tract infection

Urinary tract infection: Infants, Children, and Adolescents: IM, IV: 50 mg/kg/dose every 24 hours; maximum dose: 2,000 mg/dose. Treatment duration dependent on age of patient, response to therapy, and extent of involvement (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

No dosage adjustment is generally necessary in renal impairment; Note: If concurrent renal and hepatic dysfunction, a reduced maximum daily dose should be considered; in adults a maximum daily dose ≤2,000 mg/day is suggested.

Not dialyzable; no supplemental dose is necessary following hemodialysis or peritoneal dialysis; patients with concomitant hepatic dysfunction must be monitored closely for safety and efficacy.

Dosing: Hepatic Impairment: Pediatric

No adjustment is generally necessary in hepatic impairment; Note: If concurrent renal and hepatic dysfunction, a reduced maximum daily dose should be considered; in adults a maximum daily dose ≤2,000 mg/day is suggested.

Dosing: Adult

(For additional information see "Ceftriaxone: Drug information")

Actinomycosis, severe or extensive

Actinomycosis, severe or extensive (alternative agent) (off-label use):

IV: 1 to 2 g once daily for 4 to 6 weeks, followed by appropriate long-term oral therapy (Ref).

Bite wound infection, treatment

Bite wound infection, treatment (animal or human bite) (off-label use):

IV: 2 g once daily or 1 g every 12 hours in combination with an agent appropriate for anaerobes. Duration of treatment for established infection (which may include oral step-down therapy) is typically 5 to 14 days (Ref).

Bloodstream infection

Bloodstream infection: For pathogen-directed therapy of susceptible organisms in the absence of CNS infection:

IV: 2 g once daily (Ref). For patients with pneumococcal bacteremia, administer 2 g every 12 hours in combination with vancomycin until meningitis is ruled out (Ref). May also be given as empiric therapy for gram-negative bloodstream infection in hemodynamically stable, immunocompetent patients without health care exposures (Ref).

Duration of therapy: Usual duration is 7 to 14 days; individualize depending on source and extent of infection as well as clinical response. A 7-day duration is recommended for patients with uncomplicated Enterobacteriaceae infection who respond appropriately to antibiotic therapy (Ref).

Chronic obstructive pulmonary disease, acute exacerbation

Chronic obstructive pulmonary disease, acute exacerbation (hospitalized patients without risk factors for Pseudomonas aeruginosa) (off-label use):

IV: 1 g once daily for 5 to 7 days; may switch to oral therapy following clinical improvement (Ref).

Diabetic foot infection, moderate to severe

Diabetic foot infection, moderate to severe (off-label use):

IV: 1 to 2 g once daily in combination with other appropriate agents. Duration (which may include oral step-down therapy) is usually 2 to 4 weeks in the absence of osteomyelitis (Ref). Note: Do not use for empiric therapy of patients at risk for Pseudomonas (eg, significant water exposure, macerated wound) (Ref).

Endocarditis, prophylaxis

Endocarditis, prophylaxis (dental or invasive respiratory tract procedures) (alternative agent for patients with nonsevere, non-IgE-mediated allergy to penicillin who cannot take oral therapy) (off-label use):

IM, IV: 1 g 30 to 60 minutes before procedure; if inadvertently not given prior to the procedure, may be administered up to 2 hours after the procedure. Note: Reserve for select situations (cardiac condition with the highest risk of adverse endocarditis outcomes and procedure likely to result in bacteremia with an organism that can cause endocarditis) (Ref).

Endocarditis, treatment

Endocarditis, treatment (off-label use):

Enterococcus faecalis, native or prosthetic valve (penicillin-susceptible): Note: Recommended regimen in patients with or at risk of renal insufficiency (eg, older age, concomitant nephrotoxins) or with aminoglycoside resistance (Ref); some experts prefer this regimen for all patients with susceptible enterococcal native valve endocarditis (Ref).

IV: 2 g every 12 hours for 6 weeks in combination with ampicillin (Ref).

HACEK organisms, native or prosthetic valve: IV, IM: 2 g once daily for 4 weeks (native valve) or 6 weeks (prosthetic valve) (Ref).

Viridans group streptococci (VGS) and Streptococcus gallolyticus (Streptococcus bovis): IV, IM:

Native valve: Highly penicillin-susceptible (MIC ≤0.12 mcg/mL): 2 g once daily alone for 4 weeks or in combination with gentamicin for 2 weeks for patients with uncomplicated infection, rapid response to therapy, and no underlying renal disease (Ref).

Native valve: Relatively penicillin-resistant (MIC >0.12 to <0.5 mcg/mL), ceftriaxone-susceptible (alternative agent): 2 g once daily for 4 weeks (Ref).

Native valve: Penicillin-resistant (MIC ≥0.5 mcg/mL), ceftriaxone-susceptible (alternative agent): 2 g once daily in combination with gentamicin. The duration of this regimen is not well established; infectious diseases consultation recommended (Ref).

Prosthetic valve: Highly penicillin-susceptible (MIC ≤0.12 mcg/mL): 2 g once daily for 6 weeks (with or without concomitant gentamicin for the first 2 weeks) (Ref).

Prosthetic valve: Relatively or fully penicillin-resistant (MIC >0.12 mcg/mL), ceftriaxone-susceptible: 2 g once daily in combination with gentamicin for 6 weeks (Ref).

Intra-abdominal infection, mild to moderate, community acquired in patients without risk factors for resistance or treatment failure

Intra-abdominal infection, mild to moderate, community acquired in patients without risk factors for resistance or treatment failure:

Cholecystitis, acute:

IV: 1 to 2 g once daily; continue for 1 day after gallbladder removal or until clinical resolution in patients managed nonoperatively (Ref). Note: The addition of anaerobic therapy (eg, metronidazole) is recommended if biliary-enteric anastomosis is present (Ref).

Other intra-abdominal infections (eg, perforated appendix, diverticulitis, intra-abdominal abscess):

IV: 1 to 2 g once daily in combination with metronidazole. Total duration of therapy (which may include transition to oral antibiotics) is 4 to 5 days following adequate source control (Ref); for diverticulitis or uncomplicated appendicitis managed without intervention, duration is 7 to 10 days (Ref).

Intracranial abscess or spinal epidural abscess

Intracranial abscess (brain abscess or intracranial epidural abscess) or spinal epidural abscess (off-label use):

IV: 2 g every 12 hours; for empiric therapy, use in combination with other appropriate agents. Duration generally ranges from 4 to 8 weeks for brain abscess and spinal epidural abscess and 6 to 8 weeks for intracranial epidural abscess (Ref). Note: For postoperative neurosurgical patients and those at risk for P. aeruginosa, other regimens with expanded gram-negative coverage are preferred (Ref).

Lyme disease

Lyme disease (Borrelia spp. infection) (off-label use):

Carditis, severe disease (patients who are symptomatic, have second or third-degree AV block, or have first degree AV block with PR interval ≥300 msec):

IV: 2 g once daily until high-grade AV block resolved and PR interval <300 msec; may switch to oral therapy to complete a total of 14 to 21 days (Ref).

Acute neurologic disease (eg, meningitis or radiculopathy), patients requiring hospitalization:

IV: 2 g once daily for 14 to 21 days (Ref).

Late disease, neurologic disease:

IV: 2 g once daily for 14 to 28 days (Ref); some experts favor a duration of 28 days (Ref).

Recurrent arthritis after adequate oral regimen:

IV: 2 g once daily for 14 days; may extend to 28 days if inflammation is not resolving (Ref).

Meningitis, bacterial

Meningitis, bacterial: As a component of empiric therapy (community-acquired infections in immunocompetent patients) or pathogen-specific therapy (eg, Streptococcus pneumoniae [ceftriaxone MIC <1 mcg/mL], Neisseria meningitidis, Haemophilus influenzae, Cutibacterium acnes, and susceptible gram-negative bacilli; alternative agent for certain pathogens):

IV: 2 g every 12 hours; for empiric therapy, use in combination with other appropriate agents. Treatment duration is 7 to 21 days, depending on causative pathogen(s) and clinical response (Ref).

Meningococcal disease, chemoprophylaxis after close contact with high-risk patient

Meningococcal disease, chemoprophylaxis after close contact with high-risk patient (off-label use):

IM: 250 mg as a single dose. Note: Prophylaxis should be initiated as soon as possible following exposure (ideally <24 hours after identification of index patient) (Ref). Close contacts include persons with prolonged exposure (≥8 hours) in close proximity (<3 feet) to index patient or direct exposure to oral secretions (eg, household contacts, childcare center contacts) (Ref).

Neurobrucellosis

Neurobrucellosis (off-label use): IV: 2 g every 12 hours for 4 to 6 weeks as part of an appropriate combination regimen (Ref).

Odontogenic soft tissue infection, pyogenic

Odontogenic soft tissue infection, pyogenic (alternative agent) (off-label use):

Note: For patients unable to take penicillin (Ref).

IV: 2 g once daily in combination with metronidazole; following clinical improvement, transition to oral step-down therapy and continue antibiotics until resolution, typically for a total of 7 to 14 days. Use in addition to appropriate surgical management (eg, drainage and/or extraction) (Ref).

Osteomyelitis and/or discitis

Osteomyelitis and/or discitis:

Treatment: As a component of empiric therapy or pathogen-specific therapy (eg, Streptococci [beta-hemolytic], C. acnes, susceptible gram-negative bacilli):

IV: 2 g every 24 hours, generally for ≥6 weeks depending on patient-specific factors such as organism, extent of infection, debridement, and clinical response. Shorter courses are appropriate if the affected bone is completely resected (eg, by amputation). For empiric therapy, use as part of an appropriate combination regimen (Ref).

Prevention, following open fractures (type III [severe contamination or comminution]): IV: 2 g every 24 hours as part of an appropriate combination regimen; ideally, administer within 6 hours of injury. Duration is 72 hours after injury or up to 24 hours after wound closure (Ref). Note: For patients with risk for methicillin-resistant S. aureus (MRSA), potential water exposure, or fecal or clostridial contamination, alternative or additional antibiotics are recommended (Ref).

Otitis media, acute

Otitis media, acute (alternative agent for patients with nonsevere, non-IgE-mediated penicillin allergy):

IM, IV: 1 to 2 g once daily for 3 days (Ref).

Pneumonia, community-acquired

Pneumonia, community-acquired: Inpatients without risk factors for P. aeruginosa:

IV: 1 to 2 g once daily in combination with other appropriate agent(s) (Ref); 1 g once daily is sufficient for most hemodynamically stable hospitalized patients with community-acquired pneumonia (Ref); for critically ill patients, some experts favor the 2 g dose (Ref). Total duration (which may include oral step-down therapy) is for a minimum of 5 days; patients should be clinically stable with normal vital signs prior to discontinuation (Ref).

Prosthetic joint infection

Prosthetic joint infection: As a component of empiric therapy or pathogen-specific therapy (eg, Streptococci [beta-hemolytic], C. acnes, susceptible gram-negative bacilli):

IV: 2 g every 24 hours for 4 to 6 weeks; for empiric therapy, use as part of an appropriate combination regimen (Ref).

Rat bite fever

Rat bite fever (off-label use):

Uncomplicated infection: IV: 1 g once daily; if patient clinically improves, may switch to an oral antibiotic after 5 to 7 days to complete a 14-day course (Ref).

Serious invasive infection (including bacteremia, meningitis, endocarditis, and other focal organ involvement): IV: 2 g once daily; for patients with meningitis, increase dose to 2 g twice daily. Duration depends on the site of infection and extent of disease (eg, 4 weeks for endocarditis) (Ref).

Salmonella species infection

Salmonella species infection (alternative agent) (off-label use):

Enteric fever (Salmonella typhi and paratyphi): Empiric therapy for severe disease or an alternative directed therapy for quinolone-nonsusceptible infection:

IV: 2 g every 12 to 24 hours for 10 to 14 days. Note: May be switched to an oral regimen based on susceptibility testing, if available. Geographic location at time of acquisition impacts risk of resistance; ceftriaxone is not recommended if there is concern for extensively drug-resistant Salmonella spp. (Ref).

Nontyphoidal Salmonella GI infection:

IV: 1 to 2 g every 24 hours for 3 to 14 days (7 to 14 days in HIV-infected patients with a CD4 count ≥200 cells/mm3). Immunosuppressed patients (eg, HIV-infected with CD4 count <200 cells/mm3) warrant a longer duration of treatment (eg, weeks to months). Note: Reserve antibiotic treatment for patients with severe illness or at high risk of invasive disease (eg, extremes of age, immunosuppression); reserve parenteral therapy for those who cannot tolerate oral agents (Ref).

Nontyphoidal Salmonella bloodstream infection:

IV: 1 to 2 g every 24 hours for 14 days. Note: Immunosuppressed patients (eg, HIV-infected with CD4 count <200 cells/mm3) and those with an extraintestinal focus of infection warrant a longer duration of treatment (eg, weeks to months) (Ref).

Septic arthritis

Septic arthritis (as a component of empiric therapy for traumatic bacterial arthritis without risk factors for P. aeruginosa; pathogen-directed therapy for gram-negative bacilli):

IV: 2 g once daily. Total treatment duration is 3 to 4 weeks (in the absence of osteomyelitis), including oral step-down therapy. For empiric therapy, give as part of an appropriate combination regimen (Ref).

Sexually transmitted infections

Sexually transmitted infections:

Chancroid (due to Haemophilus ducreyi) (off-label use):

IM: 250 mg as a single dose. Note: Efficacy data in patients with HIV are limited (Ref).

Empiric treatment following sexual assault (off-label use):

IM: 500 mg (1 g in patients ≥150 kg) as a single dose, as part of an appropriate combination regimen (Ref).

Epididymitis (off-label use):

Inpatients: IV: 1 g once daily; use in combination with doxycycline for patients at risk for sexually transmitted infection. May switch to an appropriate oral regimen after patient is afebrile for 24 hours; total duration (including oral step-down therapy) is 10 to 14 days (Ref).

Outpatients: IM: 500 mg (1 g in patients ≥150 kg) as a single dose in combination with doxycycline, or for patients who practice insertive anal sex, levofloxacin (Ref).

Gonococcal infection:

Uncomplicated gonorrhea (infection of the cervix, pharynx, rectum, urethra): Note: Coverage for gonococcal infection should be included in empiric regimens for cervicitis or urethritis in patients at high risk for gonorrhea or if the community prevalence of gonorrhea is high (eg, >5%) (Ref), and in empiric regimens for proctitis in individuals who practice anal receptive sex (Ref).

IM: 500 mg as a single dose; 1 g is recommended for patients weighing ≥150 kg. Give in combination with treatment for chlamydia if it has not been excluded. A test-of-cure (culture or nucleic acid amplification test) is recommended 7 to 14 days after initial treatment of pharyngeal gonorrhea. When treatment failure is suspected (eg, detection of N. gonorrhoeae after treatment without additional sexual exposure), consult an infectious diseases specialist. Report failures to the CDC through state and local health departments (Ref).

Uncomplicated gonorrhea (conjunctivitis) (off-label use):

IM: 1 g as a single dose. Give in combination with treatment for chlamydia if it has not been excluded (Ref).

Disseminated gonococcal infection (tenosynovitis, dermatitis, polyarthralgia; purulent arthritis) (off-label use):

IV (preferred), IM: 1 g once daily. For patients with triad of tenosynovitis, dermatitis, and arthralgia or synovitis, may switch to IM ceftriaxone 500 mg (1 g in patients ≥150 kg) once daily 24 to 48 hours after clinical improvement to complete a total of ≥7 days of therapy. Patients with purulent arthritis often require ≥7 to 14 days of parenteral therapy; duration depends on clinical status and response to therapy. Note: Give in combination with treatment for chlamydia if it has not been excluded (Ref).

Pelvic inflammatory disease:

Mild to moderate: IM: 500 mg (1 g in patients ≥150 kg) as a single dose in combination with doxycycline and metronidazole (Ref).

Severe (including tubo-ovarian abscess): IV: 1 g once daily in combination with doxycycline and metronidazole; after 24 to 48 hours of sustained clinical improvement, transition to oral therapy to complete 14 days of treatment (Ref).

Syphilis (alternative agent for nonpregnant patients with nonsevere, non-IgE-mediated penicillin allergy) (off-label use):

Note: Optimal dose/duration not established; use in consultation with an expert in syphilis management (Ref). Some experts prefer the IV formulation (Ref).

Early syphilis (primary, secondary, and early latent [<1-year duration]): IM, IV: 1 g once daily for 10 to 14 days (Ref).

Late syphilis (late latent [>1-year duration] or tertiary syphilis with normal CSF examination): IM, IV: 1 to 2 g once daily for 10 to 14 days (Ref).

Neurosyphilis (including ocular and otosyphilis): Note: Penicillin is preferred; reserve ceftriaxone for when penicillin desensitization or challenge is not feasible (Ref).

IM, IV: 1 to 2 g once daily for 10 to 14 days (Ref); some experts prefer the 2 g once daily dose (Ref).

Skin and soft tissue infection

Skin and soft tissue infection (eg, select surgical site or necrotizing infections):

IV: 1 to 2 g once daily, usually as part of an appropriate combination regimen. Duration varies by extent of infection, clinical response, and other patient factors; for necrotizing infection, continue until further debridement is not necessary, patient has clinically improved, and patient is afebrile for ≥48 hours (Ref).

Spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis (off-label use):

Primary prophylaxis: Note: For patients with advanced cirrhosis and active GI bleeding (Ref).

IV: 1 g once daily; may transition to oral antibiotic prophylaxis when bleeding is controlled and oral intake is resumed. Total duration (including oral agents) is 7 days (Ref).

Treatment (alternative agent): Note: For patients without sepsis or risk for multidrug resistance (Ref).

IV: 2 g once daily; duration is for 5 to 7 days, as long as fever and pain have resolved (Ref).

Surgical prophylaxis, colorectal

Surgical prophylaxis, colorectal (alternative agent):

IV: 2 g within 60 minutes prior to surgical incision in combination with metronidazole. Note: Reserved for locations where gram-negative resistance to first- and second-generation cephalosporins is high (Ref). Postoperative prophylaxis is not recommended in clean and clean-contaminated surgeries (Ref).

Toxic shock syndrome, streptococcal

Toxic shock syndrome, streptococcal (alternative agent for patients with nonsevere, non-IgE-mediated penicillin allergy) (off-label use):

IV: 1 to 2 g every 12 hours in combination with clindamycin. Duration of therapy depends on extent and severity of infection and response to treatment; treat patients who are bacteremic for ≥14 days (Ref).

Urinary tract infection, complicated

Urinary tract infection, complicated (pyelonephritis or urinary tract infection with systemic signs/symptoms):

Note: Use empirically only in patients who do not have risk factors for multidrug-resistant organisms, critical illness, or suspected urinary tract obstruction (Ref).

Inpatients: IV: 1 g once daily. Switch to an appropriate oral regimen once symptoms improve, if culture and susceptibility results allow. Total duration of therapy ranges from 5 to 14 days and depends on clinical response and the antimicrobial chosen to complete the regimen (Ref).

Outpatients: IV, IM: 1 g once, followed by 5 to 14 days of appropriate oral therapy (Ref). Note: For patients who are systemically ill or at risk for more severe illness, some experts continue daily parenteral therapy pending culture and susceptibility testing results (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney impairment: IM, IV:

CrCl >15 mL/minute: No dosage adjustment necessary.

CrCl <15 mL/minute: No dosage adjustment necessary (Ref). Use of >2 g/day has not been studied and should be done with close monitoring, especially in patients with concurrent hepatic dysfunction (decreased biliary excretion) (Ref).

Augmented renal clearance (measured urinary CrCl ≥130 mL/minute/1.73 m2): IV: Augmented renal clearance (ARC) is a condition that occurs in certain critically ill patients without organ dysfunction and with normal serum creatinine levels. Young patients (<55 years of age) admitted post trauma or major surgery are at highest risk for ARC, as well as those with sepsis, burns, or hematological malignancies. An 8- to 24-hour measured urinary CrCl is necessary to identify these patients (Ref). Note: Dosing based on Monte Carlo simulation.

CrCl ≥150 mL/minute (empiric therapy or organism with minimum inhibitory concentration [MIC] = 2): 2 g twice daily (Ref).

Hemodialysis, intermittent (thrice weekly): IM, IV: Poorly dialyzed; no dosage adjustment necessary (Ref). Use of >2 g/day has not been studied and should be done with close monitoring, especially in patients with concurrent hepatic dysfunction (decreased biliary excretion) (Ref). Alternatively, 2 g thrice weekly post dialysis achieves pharmacodynamic goals when the MIC ≤1 mcg/mL (Ref).

Peritoneal dialysis: IM, IV: Poorly dialyzed; no dosage adjustment necessary (Ref). Use of >2 g/day has not been studied and should be done with close monitoring, especially in patients with concurrent hepatic dysfunction (decreased biliary excretion) (Ref).

CRRT: IM, IV: No dosage adjustment necessary (Ref).

PIRRT (eg, sustained, low-efficiency hemodiafiltration): IM, IV: No dosage adjustment necessary (expert opinion).

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling; however, in patients with concurrent hepatic dysfunction (impaired biliary excretion) and severe kidney impairment, use of >2 g/day should be done with caution and close monitoring for toxicity (Ref).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous [preservative free]:

Generic: 20 mg/mL (50 mL); 40 mg/mL (50 mL)

Solution Reconstituted, Injection [preservative free]:

Generic: 250 mg (1 ea); 500 mg (1 ea); 1 g (1 ea); 2 g (1 ea); 100 g (1 ea)

Solution Reconstituted, Intravenous [preservative free]:

Generic: 1 g (1 ea); 2 g (1 ea); 10 g (1 ea)

Generic Equivalent Available: US

Yes

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous:

Generic: 20 mg/mL (50 mL); 40 mg/mL (50 mL)

Solution Reconstituted, Injection:

Generic: 250 mg (1 ea); 500 mg (1 ea); 1 g (1 ea); 2 g (1 ea); 100 g (1 ea)

Solution Reconstituted, Intravenous:

Generic: 10 g (1 ea)

Administration: Pediatric

Parenteral: Do not coadminister with calcium-containing solutions.

IM: Administer IM injections deep into a large muscle mass.

Intermittent IV infusion:

Neonates: Administer over 60 minutes to decrease risk of bilirubin encephalopathy.

Infants, Children, and Adolescents: Administer over 30 minutes; shorter infusion times (15 minutes) have been reported (Ref).

Due to reports of precipitation reaction in neonates, do not reconstitute, admix, or coadminister with calcium-containing solutions (eg, LR, Hartmann's solution, parenteral nutrition), even via separate infusion lines/sites or at different times in any neonate. Ceftriaxone should not be diluted or administered simultaneously with any calcium-containing solution via a Y-site in any patient. However, ceftriaxone and calcium-containing solutions may be administered sequentially of one another for use in patients other than neonates if infusion lines are thoroughly flushed (with a compatible fluid) between infusions.

IV Push: Administration over 2 to 4 minutes has been reported in pediatric patients >11 years and adults primarily in the outpatient setting (Ref) and over 5 minutes in pediatric patients ages newborn to 15 years with meningitis (Ref). Rapid IVP injection over 5 minutes of a 2,000 mg dose resulted in tachycardia, restlessness, diaphoresis, and palpitations in an adult patient (Ref). IV push administration in young infants may also have been a contributing factor in risk of cardiopulmonary events occurring from interactions between ceftriaxone and calcium (Ref).

Administration: Adult

IM: Inject deep IM into large muscle mass; a concentration of 250 mg/mL or 350 mg/mL is recommended for all vial sizes except the 250 mg size (250 mg/mL is suggested); can be diluted with 1:1 water or 1% lidocaine for IM administration only.

IV: Infuse as an intermittent infusion over 30 minutes. IV push administration over 1 to 4 minutes has been reported (concentration: 100 mg/mL), primarily in patients outside the hospital setting (Ref), although a 2 g dose administered IV push over 5 minutes resulted in tachycardia, restlessness, diaphoresis, and palpitations in one patient (Ref). Do not coadminister with calcium-containing solutions.

Storage/Stability

Powder for injection: Prior to reconstitution, store at 20°C to 25°C (68°F to 77°F). Protect from light.

Premixed solution (manufacturer premixed):

Duplex container: Store the unactivated container at 20°C to 25°C (68°F to 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Do not freeze.

Galaxy container: Store at −20°C (−4°F); once thawed, solutions are stable for 48 hours at 25°C (77°F) or for 21 days at 5°C (41°F). Do not refreeze.

Frozen premixed solutions: Store at −20°C or below. Once thawed, solutions are stable for 48 hours at 25°C (77°F) or for 21 days at 5°C (41°F). Do not refreeze.

Stability of reconstituted solutions:

10 to 40 mg/mL: Reconstituted in D5W, D10W, NS, or SWFI: Stable for 2 days at room temperature of 25°C (77°F) or for 10 days when refrigerated at 4°C (39°F). Stable for 26 weeks when frozen at −20°C when reconstituted with D5W or NS. Once thawed (at room temperature), solutions are stable for 2 days at room temperature of 25°C (77°F) or for 10 days when refrigerated at 4°C (39°F); does not apply to manufacturer's premixed bags. Do not refreeze. If D5NS or D51/2NS are used, solutions are only stable for 2 days at of 25°C (77°F).

100 mg/mL:

Reconstituted in D5W, SWFI, or NS: Stable for 2 days at room temperature of 25°C (77°F) or for 10 days when refrigerated at 4°C (39°F).

Reconstituted in lidocaine 1% solution or bacteriostatic water: Stable for 24 hours at room temperature of 25°C (77°F) or for 10 days when refrigerated at 4°C (39°F).

250 to 350 mg/mL: Reconstituted in D5W, NS, lidocaine 1% solution, bacteriostatic water, or SWFI: Stable for 24 hours at room temperature of 25°C (77°F) or for 3 days when refrigerated at 4°C (39°F).

Use

Treatment of sepsis, meningitis, infections of the lower respiratory tract, acute bacterial otitis media, skin and skin structure, bone and joint, intra-abdominal and urinary tract due to susceptible organisms (FDA approved in infants, children, adolescents, and adults); surgical prophylaxis (FDA approved in adults); documented or suspected uncomplicated gonococcal infection or pelvic inflammatory disease (FDA approved for adults); has also been used for the treatment of endocarditis, Lyme disease, acute bacterial rhinosinusitis, salmonellosis, shigellosis, syphilis, and typhoid fever and prophylaxis of peritonitis in patients undergoing invasive dental procedures.

Medication Safety Issues
Sound-alike/look-alike issues:

CefTRIAXone may be confused with ceFAZolin, cefoTEtan, cefOXitin, cefTAZidime, Cetraxal

Rocephin may be confused with Roferon

Pediatric patients: High-risk medication:

KIDs List: Ceftriaxone, when used in neonates, is identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list and should be used with caution due to risk of kernicterus (weak recommendation; very low quality of evidence) (PPA [Meyers 2020]).

Adverse Reactions (Significant): Considerations
Ceftriaxone-calcium precipitation

Ceftriaxone-calcium precipitation has occurred, leading to fatal lung and kidney damage in premature and term neonates. Urinary sludge (hypercalciuria), nephrolithiasis, urolithiasis, and acute renal failure have been reported (Ref). Gallbladder sludge, cholelithiasis, and pseudolithiasis (choledocholithiasis), as well as subsequent pancreatitis, have also occurred. Most reports have occurred in pediatric patients; however, there are reports in adults (Ref).

Mechanism : Incompatibility with calcium, resulting in ceftriaxone-calcium precipitates; pancreatitis occurs subsequent to biliary obstruction.

Onset: Varied; 2 to 18 days after last dose for detection via ultrasound of gallbladder sludge, cholelithiasis, or pseudolithiasis in pediatric patients (Ref).

Risk factors:

• Pediatric patients (Ref); age ≥12 to 24 months (for biliary precipitation) (Ref)

• High doses (>40 mg/kg/day or ≥2 g) (Ref)

• Longer durations of treatment (>5 days) (Ref)

• Impaired gallbladder emptying (Ref)

• Biliary stasis risk factors (eg, major surgery, severe illness, TPN)

Clostridioides difficile infection

Clostridioides difficile infection has occurred, including Clostridioides difficile associated diarrhea and Clostridioides difficile colitis.

Onset: Variable; may start on the first day of antibiotic therapy or up to 3 months postantibiotic (Ref).

Risk factors:

• Antibiotic exposure (highest risk factor) (Ref)

• Type of antibiotic (third-/fourth-generation cephalosporins among the highest risk) (Ref)

• Long durations in a hospital or other health care setting (recent or current) (Ref)

• Older adults (Ref)

• Immunocompromised conditions (Ref)

• A serious underlying condition (Ref)

• GI surgery/manipulation (Ref)

• Antiulcer medications (eg, proton pump inhibitors and H2 blockers) (Ref)

• Chemotherapy (Ref)

Hemolytic anemia

Immune hemolytic anemia has occurred in patients receiving cephalosporins, including ceftriaxone (Ref).

Mechanism: Non dose-related; immunologic (ie, induces complement activating drug-dependent antibodies [mainly IgM-type] resulting in immune-complexes) (Ref).

Onset: Varied; occurs several minutes to 7 days after the first dose (Ref).

Risk factors:

• Pediatric patients (Ref)

• Sickle cell disease (Ref)

• Cross-reactivity with other cephalosporins (Ref)

Hypersensitivity reactions (immediate and delayed)

Hypersensitivity reactions (immediate and delayed) range from maculopapular skin rash to rare cases of anaphylaxis and anaphylactic shock. Severe cutaneous adverse reactions (SCARs), including acute generalized exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) have been reported. (Ref). Urticaria and serum sickness-like reaction have also occurred (Ref).

Mechanism: Non dose-related; immunologic. Immediate hypersensitivity reactions (eg, anaphylaxis, urticaria) are IgE-mediated. Delayed hypersensitivity reactions, including maculopapular rash and SCARs, are T-cell-mediated (Ref).

Onset: Immediate hypersensitivity reactions: rapid; occur within 1 hour of administration but may occur up to 6 hours after exposure (Ref). Delayed hypersensitivity reactions: Maculopapular reactions: intermediate; occur 7 to 10 days after initiation. Other reactions (including SCARs): varied; occur after 7 to 14 days up to 3 months (Ref).

Risk factors:

• Cross-reactivity between penicillins and cephalosporins and among cephalosporins is mostly related to side chain similarity (Ref)). A meta-analysis showed negligible cross-reactivity between penicillins and third-generation cephalosporins, such as ceftriaxone (Ref).

Kernicterus

Kernicterus has been reported in neonates, resulting from hyperbilirubinemia (increased serum bilirubin).

Mechanism: Displaces bilirubin from albumin, resulting in higher concentrations of free unconjugated bilirubin, leading to kernicterus (Ref).

Risk factors:

• Neonates, especially premature infants

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%:

Dermatologic: Skin tightness (IM: ≤5% to ≤17%; local)

Local: Induration at injection site (≤5% to ≤17%; incidence higher with IM), warm sensation at injection site (IM: ≤5% to ≤17%)

1% to 10%:

Cardiovascular: Flushing (≤6%)

Dermatologic: Diaphoresis (≤6%), pruritus (≤6%), skin rash (≤6%)

Gastrointestinal: Clostridioides difficile colitis (≤6%), diarrhea (≤6%), dysgeusia (≤6%), nausea (≤6%), vomiting (≤6%)

Genitourinary: Casts in urine (≤6%), vaginitis (≤6%)

Hematologic & oncologic: Anemia (≤6%), eosinophilia (≤6%), hemolytic anemia (≤6%), leukopenia (≤6%), lymphocytopenia (≤6%), neutropenia (≤6%), prolonged prothrombin time (≤6%), thrombocythemia (≤6%), thrombocytopenia (≤6%)

Hepatic: Increased serum alanine aminotransferase (≤6%), increased serum alkaline phosphatase (≤6%), increased serum aspartate aminotransferase (≤6%), increased serum bilirubin (≤6%)

Infection: Candidiasis (≤6%)

Local: Injection site phlebitis (≤6%), pain at injection site (≤6%), tenderness at injection site (≤6%)

Nervous system: Chills (≤6%), dizziness (≤6%), headache (≤6%)

Renal: Increased blood urea nitrogen (≤6%), increased serum creatinine (≤6%)

<1%:

Cardiovascular: Palpitations

Endocrine & metabolic: Glycosuria

Gastrointestinal: Abdominal pain, choledocholithiasis, cholelithiasis, dyspepsia, flatulence, gallbladder sludge, pancreatitis

Genitourinary: Hematuria

Hematologic & oncologic: Agranulocytosis, basophilia, decreased prothrombin time, granulocytopenia, lymphocytosis, monocytosis

Hepatic: Jaundice

Hypersensitivity: Anaphylaxis, serum sickness

Nervous system: Seizure

Renal: Nephrolithiasis

Respiratory: Bronchospasm, epistaxis, hypersensitivity pneumonitis

Postmarketing:

Dermatologic: Acute generalized exanthematous pustulosis (Salman 2019), allergic dermatitis, erythema multiforme, Stevens-Johnson syndrome (Liberopoulos 2003), toxic epidermal necrolysis (Atanaskovic-Markovic 2013; Lam 2008), urticaria (Baniasadi 2007)

Gastrointestinal: Clostridioides difficile associated diarrhea, glossitis, stomatitis

Genitourinary: Hypercalciuria (Zeng 2020), oliguria (Shen 2014), ureteral obstruction (Lu 2012), urolithiasis (Shen 2014)

Hepatic: Hepatitis (Peker 2009)

Hypersensitivity: Anaphylactic shock (Calapai 2016)

Immunologic: Drug reaction with eosinophilia and systemic symptoms (Hansel 2017)

Nervous system: Encephalopathy (Roncon-Albuquerque 2009), kernicterus, neurotoxicity (including myoclonus [Hagiya 2017] and nonconvulsive status epilepticus [Kim 2012])

Renal: Acute kidney injury (post-renal) (Li 2014; Shen 2014)

Contraindications

Hypersensitivity to ceftriaxone, any component of the formulation, or other cephalosporins; do not use in hyperbilirubinemic neonates, particularly those who are premature since ceftriaxone is reported to displace bilirubin from albumin binding sites; concomitant use with intravenous calcium-containing solutions/products in neonates (≤28 days); IV use of ceftriaxone solutions containing lidocaine.

Warnings/Precautions

Concerns related to adverse effects:

• Elevated INR: May be associated with increased INR (rarely), especially in nutritionally deficient patients, prolonged treatment, hepatic or renal disease. Monitor INR during treatment if patient has impaired synthesis or low stores of vitamin K; supplementation may be needed if clinically indicated.

• Superinfection: Prolonged use may result in fungal or bacterial superinfection.

Disease-related concerns:

• Renal/hepatic impairment (concurrent): Use with caution in patients with concurrent hepatic dysfunction (impaired biliary excretion) and severe kidney disease; dosing adjustments may be recommended.

Special populations:

• Neonates: Use extreme caution in neonates due to risk of hyperbilirubinemia, particularly in premature infants (contraindicated in hyperbilirubinemic neonates and neonates <41 weeks postmenstrual age).

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program

Aminoglycosides: Cephalosporins may enhance the nephrotoxic effect of Aminoglycosides. Cephalosporins may decrease the serum concentration of Aminoglycosides. Risk C: Monitor therapy

Bacillus clausii: Antibiotics may diminish the therapeutic effect of Bacillus clausii. Management: Bacillus clausii should be taken in between antibiotic doses during concomitant therapy. Risk D: Consider therapy modification

BCG (Intravesical): Antibiotics may diminish the therapeutic effect of BCG (Intravesical). Risk X: Avoid combination

BCG Vaccine (Immunization): Antibiotics may diminish the therapeutic effect of BCG Vaccine (Immunization). Risk C: Monitor therapy

Calcium Salts (Intravenous): May enhance the adverse/toxic effect of CefTRIAXone. Ceftriaxone binds to calcium forming an insoluble precipitate. Management: Use of ceftriaxone is contraindicated in neonates (28 days of age or younger) who require (or are expected to require) treatment with IV calcium-containing solutions. In older patients, flush lines with compatible fluid between administration. Risk D: Consider therapy modification

Cholera Vaccine: Antibiotics may diminish the therapeutic effect of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics. Risk X: Avoid combination

Furosemide: May enhance the nephrotoxic effect of Cephalosporins. Risk C: Monitor therapy

Immune Checkpoint Inhibitors: Antibiotics may diminish the therapeutic effect of Immune Checkpoint Inhibitors. Risk C: Monitor therapy

Lactobacillus and Estriol: Antibiotics may diminish the therapeutic effect of Lactobacillus and Estriol. Risk C: Monitor therapy

Probenecid: May increase the serum concentration of Cephalosporins. Risk C: Monitor therapy

Ringer's Injection (Lactated): May enhance the adverse/toxic effect of CefTRIAXone. Ceftriaxone binds to calcium in the Lactated Ringer's forming an insoluble precipitate. Management: Use of ceftriaxone is contraindicated in neonates (28 days of age or younger) who require (or are expected to require) treatment with IV calcium-containing solutions (ie, LR). In older patients, flush lines with compatible fluid between administration. Risk D: Consider therapy modification

Sodium Picosulfate: Antibiotics may diminish the therapeutic effect of Sodium Picosulfate. Management: Consider using an alternative product for bowel cleansing prior to a colonoscopy in patients who have recently used or are concurrently using an antibiotic. Risk D: Consider therapy modification

Typhoid Vaccine: Antibiotics may diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Avoid use of live attenuated typhoid vaccine (Ty21a) in patients being treated with systemic antibacterial agents. Postpone vaccination until 3 days after cessation of antibiotics and avoid starting antibiotics within 3 days of last vaccine dose. Risk D: Consider therapy modification

Vitamin K Antagonists (eg, warfarin): Cephalosporins may enhance the anticoagulant effect of Vitamin K Antagonists. Risk C: Monitor therapy

Dietary Considerations

Some products may contain sodium.

Pregnancy Considerations

Ceftriaxone crosses the placenta.

Based on available data, cephalosporin antibiotics are generally considered compatible for use during pregnancy.

Pregnancy was found to influence the single dose pharmacokinetics of ceftriaxone when administered prior to delivery (Popović 2007). The pharmacokinetics of ceftriaxone following multiple doses in the third trimester are similar to those of nonpregnant patients (Bourget 1993a).

Ceftriaxone is recommended for use in pregnant patients for the treatment of gonococcal infections, Lyme disease, and may be used in certain situations prior to vaginal delivery in patients at high risk for endocarditis (consult current guidelines) (ACOG 2018; CDC [Workowski 2021]; IDSA/AAN/ACR [Lantos 2021]; Lambert 2020). Ceftriaxone should not be used as an alternative agent in penicillin-allergic pregnant patients for the treatment of maternal syphilis or the prevention of congenital syphilis (CDC [Workowski 2021]).

Monitoring Parameters

CBC with differential, platelet count, PT, renal and hepatic function tests periodically; number and type of stools/day for diarrhea; observe for signs and symptoms of anaphylaxis.

Mechanism of Action

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Pharmacokinetics (Adult data unless noted)

Absorption: IM: Well absorbed.

Distribution: Widely throughout the body including gallbladder, lungs, bone, bile, CSF (higher concentrations achieved when meninges are inflamed).

Vd:

Neonates: 0.34 to 0.55 L/kg (Richards 1984).

Infants and Children: 0.32 to 0.4 L/kg (Richards 1984).

Adults: ~6 to 14 L.

CSF:blood ratio: ~14% (range: 6% to 66%) (Grégoire 2019).

Pleural fluid:serum ratio: ~27% to 29% (range: 1% to 63%) (Goonetilleke 1996).

Protein binding: 85% to 95%.

Half-life elimination:

Neonates: 1 to 4 days: 16 hours; 9 to 30 days: 9 hours (Martin 1984).

Infants and Children: 4 to 6.6 hours (Richards 1984).

Adults: Normal renal and hepatic function: ~5 to 9 hours.

Adults: Renal impairment (mild to severe): ~12 to 16 hours.

Time to peak, serum: IM: 2 to 3 hours.

Excretion: Urine (33% to 67% as unchanged drug); feces (as inactive drug).

Pharmacokinetics: Additional Considerations

Anti-infective considerations:

Parameters associated with efficacy:

Time dependent; associated with time free drug concentration (fT) > minimum inhibitory concentration (MIC):

Organism specific:

Enterobacterales: Goal: ≥ ~38% fT > MIC (bacteriostatic); ≥ ~60% to 70% fT > MIC (bactericidal) (Craig 1995; Turnidge 1998).

S. pneumoniae: ≥ ~40% fT > MIC (bacteriostatic) (Craig 1995; Craig 1998; Turnidge 1998).

Population specific:

Critically ill patients in the ICU: Minimum goal: ≥50% fT > MIC; preferred goal: ≥100% fT > MIC (Roberts 2014); some experts favor ≥100% fT >4 times the MIC (Guilhaumou 2019).

Expected drug exposure in normal renal function:

Neonates and Infants: Cmax (peak): IV: 50 mg/kg, single dose: ~136 to 184 mg/L (Chadwick 1983; McCracken 1983).

Infants and Children ≤3 years of age: Cmax (peak): IV:

50 mg/kg, single dose: 207 mg/L (range: 120 to 375 mg/L) (Del Rio 1982).

50 mg/kg every 12 hours, steady state: 263 mg/L (range: 150 to 410 mg/L) (Del Rio 1982).

Adults: Cmax (peak): IV:

1 g once daily, steady state: ~136.4 ± 21.2 mg/L (Chiu 2002).

1 g every 12 hours, steady state: 168 ± 25 mg/L (Pollock 1982).

2 g every 12 hours, steady state: 280 ± 39 mg/L (Pollock 1982).

Postantibiotic effect: Generally <1 hour; varies based on organism (Aldridge 2002; Buxbaum 1996; Craig 1993).

Additional Information

Rocephin contains 3.6 mEq sodium per gram of ceftriaxone.

Pricing: US

Solution (cefTRIAXone Sodium in Dextrose Intravenous)

20 mg/mL (per mL): $0.34

40 mg/mL (per mL): $0.81

Solution (reconstituted) (cefTRIAXone Sodium Injection)

1 g (per each): $1.49 - $46.75

2 g (per each): $2.65 - $91.72

100 g (per each): $270.00

250 mg (per each): $0.91 - $15.94

500 mg (per each): $1.16 - $27.99

Solution (reconstituted) (cefTRIAXone Sodium Intravenous)

1 g (per each): $4.97 - $46.75

2 g (per each): $9.56 - $91.72

10 g (per each): $19.06 - $448.43

Solution (reconstituted) (cefTRIAXone Sodium-Dextrose Intravenous)

1GM 3.74%(50ML) (per each): $20.43

2GM 2.22%(50ML) (per each): $29.21

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Brand Names: International
  • 3 Gen-1000 (PH);
  • Acantex (AR, CL);
  • Aciphin (BD);
  • Acrocef (EC);
  • Actaxon (ID);
  • Alcizon (ET);
  • Alcizone (UA);
  • Alvobak (UA);
  • Amcef (MX);
  • Amplospec (BR);
  • Aumax (VN);
  • Aurofox (MX);
  • Axobat (IT);
  • Axone (AE, CY, IQ, IR, JO, KW, LB, LY, OM, SA, SY, YE);
  • Axtar (CR, DO, GT, HN, MX, NI, PA, SV);
  • Benaxona (MX);
  • Biotriax (ID);
  • Broadced (ID);
  • Brospec (ID);
  • Cafalogen (PE);
  • Carotan (PE);
  • Cef-S (PH);
  • Cef-Zone (TH);
  • Cefacrol (PE);
  • Cefaxona (MX);
  • Cefaxone (MY, SG, UA);
  • Cefilan (PL);
  • Cefin (SG);
  • Cefizon (LK);
  • Cefkizon (KR);
  • Cefogram (UA);
  • Cefort (RO);
  • Cefotrix (AT);
  • Cefraden (MX);
  • Ceftash (ET);
  • Ceftral (LK);
  • Ceftrax (EG);
  • Ceftrex (MX, TH);
  • Ceftrian (EC);
  • Ceftrianol (MX);
  • Ceftriax-1 (PH);
  • Ceftrifil (PH);
  • Ceftrilem (MX);
  • Ceftritina (VN);
  • Ceftron (LK);
  • Cefxon (ID);
  • Celltriaxon (MY);
  • Ceptaxone (KR);
  • Cerixon (KR);
  • Cetriaf (DO);
  • Chef (TW);
  • Cikedrix (PH);
  • Diacef (UA);
  • Ecotrixon (ID);
  • Elpicef (ID);
  • Epicephin (BH);
  • Eroxet (PH);
  • Erphacef (ID);
  • Excephin (ET);
  • Exempla (AR);
  • Ferfacef (ID);
  • Forgram (PH);
  • Gomcephin (KR);
  • Infecef (BD);
  • Ivixone (TZ);
  • Keptrix (PH);
  • Kocef (ZA);
  • Lendacin (HU);
  • Longacef (AE, CY, EG, IQ, IR, JO, KW, LY, OM, SA, SY, YE);
  • Lyceft (IN);
  • Megion (AE, BH, CR, GT, HN, JO, KW, LB, MX, NI, PA, PH, QA, SA, SV);
  • Mesporin (AE, BF, BJ, CI, CY, EE, ET, GH, GM, GN, IQ, IR, JO, KE, KW, LR, LY, MA, ML, MR, MU, MW, MY, NE, NG, OM, QA, SA, SC, SD, SL, SN, SY, TN, TT, TZ, UG, YE, ZM, ZW);
  • Mesporin IM (BB, BM, BS, BZ, GY, HK, JM, PR, SR);
  • Mesporin IV (BB, BM, BS, BZ, GY, HK, JM, PR, SR);
  • Monocef (IN);
  • Nectram (TH);
  • Newcef (KR);
  • Novosef (AE, CY, IQ, IR, JO, KW, LY, OM, PH, RU, SA, SY, TR, YE);
  • Oframax (BF, BJ, CI, EG, ET, GH, GM, GN, IN, KE, LR, MA, ML, MR, MU, MW, NE, NG, SC, SD, SG, SL, SN, TN, TZ, UG, VN, ZA, ZM, ZW);
  • Oncef (PH);
  • Pan-Ceftriaxone (IL);
  • Pantrixon (PH);
  • Powergef (TZ);
  • Ragex (IT);
  • Retrokor (PH);
  • Riaxon (GR);
  • Rocefin (BR, CO, IT);
  • Rocefort (CR, DO, GT, HN, NI, PA, SV);
  • Rocephalin (DK, FI, IS, NO, SE);
  • Rocephin (AE, AT, AU, BH, CH, CN, CU, CY, DE, EC, EG, GB, GH, HK, HU, IE, IQ, IR, JO, JP, KE, KR, KW, LB, LV, LY, MT, MX, OM, PE, PH, PK, PL, PT, PY, QA, RO, SA, SG, SY, TH, TW, TZ, UG, UY, VE, VN, YE, ZM);
  • Rocephine (BE, FR, LU);
  • Rocidar (AE, CY, IQ, IR, JO, KW, LY, OM, SA, SY, YE);
  • Roxcef (BF, BH, BJ, CI, ET, GH, GM, GN, KE, LR, MA, ML, MR, MU, MW, NE, NG, SC, SD, SL, SN, TN, TZ, UG, ZM, ZW);
  • Samixon (AE, BH, CY, IQ, IR, JO, KW, LY, OM, QA, SA, SY, YE);
  • Socef (ID);
  • Tacex (MX);
  • Terbac (MX);
  • Tercef (BG);
  • Tiaxone (AU);
  • Traxef (BD);
  • Traxol (ZW);
  • Trexofin (SG);
  • Triaken (MX);
  • Triax-1 (PH);
  • Triaxon (BR);
  • Triaxone (AE, BH, ET, KR, KW, LB, SA, SG);
  • Tricef (TW);
  • Tricefin (SG);
  • Trijec (ID);
  • Triox (MX);
  • Trixone (MY);
  • Trizon (BD);
  • U-Ron (TW);
  • Unocef (MY);
  • Utrixone (ZW);
  • Vaxcel (LK);
  • Veracol (GR, NZ);
  • Viatrex (PH);
  • Xone (ZW);
  • Xtenda (PH);
  • Zefone 250 (BF, BJ, CI, ET, GH, GM, GN, KE, LR, MA, ML, MR, MU, MW, NE, NG, SC, SD, SL, SN, TN, TZ, UG, ZM, ZW);
  • Zeftrox (LK);
  • Zeptri (PH);
  • Zontrixone (TH)


For country code abbreviations (show table)
  1. Aldridge KE. Comparison of the post-antibiotic effect (PAE) induced by ceftizoxime, ceftriaxone, cefoxitin, ampicillin-sulbactam, and ticarcillin-clavulanate against selected isolates of Bacteroides fragilis and B. thetaiotaomicron. Anaerobe. 2002;8(6):295-299. doi:10.1016/S1075-9964(03)00024-6 [PubMed 16887672]
  2. American Academy of Pediatrics (AAP). In: Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH, eds. Red Book: 2021-2024 Report of the Committee on Infectious Diseases. 32nd ed. American Academy of Pediatrics; 2021.
  3. American College of Obstetricians and Gynecologists (ACOG), Committee on Practice Bulletins-Obstetrics. ACOG practice bulletin no. 199: use of prophylactic antibiotics in labor and delivery. Obstet Gynecol. 2018;132(3):e103‐e119. doi:10.1097/AOG.0000000000002833
  4. Anderson PO, Sauberan JB. Modeling drug passage into human milk. Clin Pharmacol Ther. 2016;100(1):42-52. [PubMed 27060684]
  5. Andrews J, John J, Charles RC. Enteric (typhoid and paratyphoid) fever: Treatment and prevention. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 21, 2021.
  6. Apicella M. Treatment and prevention of meningococcal infection. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed April 10, 2019.
  7. Arjyal A, Basnyat B, Nhan HT, et al. Gatifloxacin versus ceftriaxone for uncomplicated enteric fever in Nepal: an open-label, two-centre, randomised controlled trial. Lancet Infect Dis. 2016;16(5):535-545. doi:10.1016/S1473-3099(15)00530-7 [PubMed 26809813]
  8. Aronoff GR, Bennett WM, Berns JS, et al. Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children. 5th ed. Philadelphia, PA: American College of Physicians; 2007:61, 153.
  9. Atanasković-Marković M, Medjo B, Gavrović-Jankulović M, Ćirković Veličković T, Nikolić D, Nestorović B. Stevens-Johnson syndrome and toxic epidermal necrolysis in children. Pediatr Allergy Immunol. 2013;24(7):645‐649. doi:10.1111/pai.12121 [PubMed 24028417]
  10. Baddour LM. Animal bites (dogs, cats, and other animals): evaluation and management. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed December 16, 2019a.
  11. Baddour LM. Human bites: evaluation and management. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed December 16, 2019b.
  12. Baddour LM, Wilson WR, Bayer AS, et al; American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young, Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and Stroke Council. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association [published correction appears in Circulation. 2015;132(17):e215]. Circulation. 2015;132(15):1435-1486. doi:10.1161/CIR.0000000000000296 [PubMed 26373316]
  13. Balighian E, Burke M. Urinary tract infections in children. Pediatr Rev. 2018;39(1):3-12. [PubMed 29292282]
  14. Baltimore RS, Gewitz M, Baddour LM, et al; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young and the Council on Cardiovascular and Stroke Nursing. Infective endocarditis in childhood: 2015 update: a scientific statement from the American Heart Association. Circulation. 2015;132(15):1487-1515. doi:10.1161/CIR.0000000000000298 [PubMed 26373317]
  15. Baniasadi S, Fahimi F, Mansouri D. Serum sickness-like reaction associated with cefuroxime and ceftriaxone. Ann Pharmacother. 2007;41(7):1318‐1319. doi:10.1345/aph.1K146 [PubMed 17578881]
  16. Based on expert opinion.
  17. Barlam TF, Cosgrove SE, Abbo LM, et al. Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis. 2016;62(10):e51‐e77. doi:10.1093/cid/ciw118 [PubMed 27080992]
  18. Barshak MB. Antimicrobial approach to intra-abdominal infections in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed June 8, 2021.
  19. Bartkowska-Śniatkowska A, Jończyk-Potoczna K, Zielińska M, Rosada-Kurasińska J. Adverse reaction to ceftriaxone in a 28-day-old infant undergoing urgent craniotomy due to epidural hematoma: review of neonatal biliary pseudolithiasis. Ther Clin Risk Manag. 2015;11:1035‐1041. doi:10.2147/TCRM.S79419 [PubMed 26170682]
  20. Baumgartner JD, Glauser MP. Single Daily Dose Treatment of Severe Refractory Infections With Ceftriaxone. Cost Savings and Possible Parenteral Outpatient Treatment. Arch Intern Med. 1983;143(10):1868-1873. [PubMed 6312914]
  21. Berbari E, Baddour LM. Prosthetic joint infection: treatment. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed May 16, 2022.
  22. Berbari EF, Kanj SS, Kowalski TJ, et al; Infectious Diseases Society of America. 2015 Infectious Diseases Society of America (IDSA) clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults. Clin Infect Dis. 2015;61(6):e26-e46. doi:10.1093/cid/civ482 [PubMed 26229122]
  23. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al; Healthcare Infection Control Practices Advisory Committee. Centers for Disease Control and Prevention guideline for the prevention of surgical site Infection, 2017. JAMA Surg. 2017;152(8):784-791. doi:10.1001/jamasurg.2017.0904 [PubMed 28467526]
  24. Bickford CL, Spencer AP. Biliary sludge and hyperbilirubinemia associated with ceftriaxone in an adult: case report and review of the literature. Pharmacotherapy. 2005;25(10):1389‐1395. doi:10.1592/phco.2005.25.10.1389 [PubMed 16185184]
  25. Biggins SW, Angeli P, Garcia-Tsao G, et al. Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021;74(2):1014-1048. doi:10.1002/hep.31884 [PubMed 33942342]
  26. Bilbao-Meseguer I, Rodríguez-Gascón A, Barrasa H, Isla A, Solinís MÁ. Augmented renal clearance in critically ill patients: a systematic review. Clin Pharmacokinet. 2018;57(9):1107-1121. doi:10.1007/s40262-018-0636-7 [PubMed 29441476]
  27. Bilukha OO, Rosenstein N; National Center for Infectious Diseases. Centers for Disease Control and Prevention (CDC). Prevention and control of meningococcal disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2005;54(RR-7):1-17. http://www.cdc.gov/mmwr/PDF/rr/rr5407.pdf. [PubMed 15917737]
  28. Biner B, Celtik C, Oner N, et al. The comparison of single-dose ceftriaxone, five-day azithromycin, and ten-day amoxicillin/clavulanate for the treatment of children with acute otitis media. Turk J Pediatr. 2007;49(4):390-396. [PubMed 18246740]
  29. Blumenthal KG, Peter JG, Trubiano JA, Phillips EJ. Antibiotic allergy. Lancet. 2019;393(10167):183‐198. doi:10.1016/S0140-6736(18)32218-9 [PubMed 30558872]
  30. Bosilkovski M, Keramat F, Arapović J. The current therapeutical strategies in human brucellosis. Infection. 2021;49(5):823-832. doi:10.1007/s15010-021-01586-w [PubMed 33650077]
  31. Bouferraa Y, Bou Zerdan M, Hamouche R, Azar E, Afif C, Jabbour R. Neurobrucellosis: brief review. Neurologist. 2021;26(6):248-252. doi:10.1097/NRL.0000000000000348 [PubMed 34734902]
  32. Bourget P, Fernandez H, Quinquis V, Delouis C. Pharmacokinetics and protein binding of ceftriaxone during pregnancy. Antimicrob Agents Chemother. 1993a;37(1):54-59. [PubMed 8431018]
  33. Bourget P, Quinquis-Desmaris V, Fernandez H. Ceftriaxone distribution and protein binding between maternal blood and milk postpartum. Ann Pharmacother. 1993b;27(3):294-297. doi:10.1177/106002809302700306 [PubMed 8453163]
  34. Bradley JS, Byington CL, Shah SS, et al. The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011;53(7):e25-e76. [PubMed 21880587]
  35. Bradley JS, Nelson JD, Barnett ED, et al, eds. Nelson's Pediatric Microbial Therapy. 27th ed. American Academy of Pediatrics; 2021.
  36. Bradley JS, Wassel RT, Lee L, et al. Intravenous Ceftriaxone and Calcium in the Neonate Assessing the Risk for Cardiopulmonary Adverse Events. Pediatrics. 2009;123(4):e609-e613. [PubMed 19289450]
  37. Bratzler DW, Dellinger EP, Olsen KM, et al; American Society of Health-System Pharmacists; Infectious Diseases Society of America; Surgical Infection Society; Society for Healthcare Epidemiology of America. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70(3):195-283. [PubMed 23327981]
  38. Britton RA, Young VB. Role of the intestinal microbiota in resistance to colonization by Clostridium difficile. Gastroenterology. 2014;146(6):1547‐1553. doi:10.1053/j.gastro.2014.01.059 [PubMed 24503131]
  39. Brockow K, Przybilla B, Aberer W, et al. Guideline for the diagnosis of drug hypersensitivity reactions: S2K-Guideline of the German Society for Allergology and Clinical Immunology (DGAKI) and the German Dermatological Society (DDG) in collaboration with the Association of German Allergologists (AeDA), the German Society for Pediatric Allergology and Environmental Medicine (GPA), the German Contact Dermatitis Research Group (DKG), the Swiss Society for Allergy and Immunology (SGAI), the Austrian Society for Allergology and Immunology (ÖGAI), the German Academy of Allergology and Environmental Medicine (DAAU), the German Center for Documentation of Severe Skin Reactions and the German Federal Institute for Drugs and Medical Products (BfArM). Allergo J Int. 2015;24(3):94‐105. doi:10.1007/s40629-015-0052-6 [PubMed 26120552]
  40. Brook I. Treatment of actinomycosis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed February 11, 2020.
  41. Brouwer MC, Tunkel AR, McKhann GM 2nd, van de Beek D. Brain abscess. N Engl J Med. 2014;371(5):447-456. [PubMed 25075836]
  42. Brown KA, Khanafer N, Daneman N, Fisman DN. Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection. Antimicrob Agents Chemother. 2013;57(5):2326‐2332. doi:10.1128/AAC.02176-12 [PubMed 23478961]
  43. Buxbaum A, Georgopoulos A. Postantibiotic effect of ceftriaxone and gentamicin alone and in combination on Klebsiella pneumoniae, Pseudomonas aeruginosa and Streptococcus viridans. Infection. 1996;24(6):459-464. doi:10.1007/BF01713048 [PubMed 9007594]
  44. Calapai G, Imbesi S, Ventura-Spagnolo E, et al. Fatal anaphylactic shock ceftriaxone-induced in a 4-year-old child. Pediatr Emerg Care. 2016;32(1):32-33. [PubMed 25513979]
  45. Cao Y, Su X, Wang Q, Xue H, et al. A multicenter study evaluating ceftriaxone and benzathine penicillin g as treatment agents for early syphilis in Jiangsu, China. Clin Infect Dis. 2017;65(10):1683-1688. doi:10.1093/cid/cix611 [PubMed 29020150]
  46. Ceftriaxone injection [prescribing information]. Cherry Hill, NJ: Samson; November 2020.
  47. Ceftriaxone injection [prescribing information]. Lehi, UT: Civica, Inc; February 2021.
  48. Ceftriaxone injection vials [prescribing information]. Eatontown, NJ: West-Ward Pharmaceuticals; July 2018.
  49. Ceftriaxone injection vials [prescribing information]. Pomona, CA: Cephazone; August 2012.
  50. Ceftriaxone sodium and dextrose injection Duplex container [prescribing information]. Bethlehem, PA: B. Braun Medical Inc; January 2022.
  51. Ceftriaxone sodium and dextrose injection Galaxy container [prescribing information]. Deerfield, IL: Baxter; January 2022.
  52. Centers for Disease Control and Prevention (CDC). FAQs for clinicians about C. diff. March 27, 2020. https://www.cdc.gov/cdiff/clinicians/faq.html. Accessed May 4, 2020.
  53. Centers for Disease Control and Prevention (CDC). Salmonella: Information for Healthcare Professionals and Laboratories. March 9, 2015. https://www.cdc.gov/salmonella/general/technical.html. Accessed December 12, 2017.
  54. Chadwick EG, Yogev R, Shulman ST, Weinfeld RE, Patel IH. Single-dose ceftriaxone pharmacokinetics in pediatric patients with central nervous system infections. J Pediatr. 1983;102(1):134-137. doi:10.1016/s0022-3476(83)80311-4 [PubMed 6294263]
  55. Chiu LM, Menhinick AM, Johnson PW, Amsden GW. Pharmacokinetics of intravenous azithromycin and ceftriaxone when administered alone and concurrently to healthy volunteers. J Antimicrob Chemother. 2002;50(6):1075-1079. doi:10.1093/jac/dkg003 [PubMed 12461037]
  56. Chow AW. Complications, diagnosis, and treatment of odontogenic infections. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed August 9, 2022.
  57. Chow AW, Benninger MS, Brook I, et al. IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults. Clin Infect Dis. 2012;54(8):e72-e112. [PubMed 22438350]
  58. Chu VH. Antimicrobial therapy of left-sided native valve endocarditis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed December 8, 2020.
  59. Clay PG, Graham MR, Lindsey CC, Lamp KC, Freeman C, Glaros A. Clinical efficacy, tolerability, and cost savings associated with the use of open-label metronidazole plus ceftriaxone once daily compared with ticarcillin/clavulanate every 6 hours as empiric treatment for diabetic lower-extremity infections in older males. Am J Geriatr Pharmacother. 2004;2(3):181-189. doi:10.1016/j.amjopharm.2004.09.006 [PubMed 15561650]
  60. Coiffier G, Alber JD. Is ceftriaxone 2 g once daily a valid treatment option for osteoarticular infections due to Staphylococcus spp., Streptococcus spp., and Gram-negative rods? Joint Bone Spine. 2014;81(3):200-202. [PubMed 24703397]
  61. Collins CE, Ayturk MD, Flahive JM, Emhoff TA, Anderson FA Jr, Santry HP. Epidemiology and outcomes of community-acquired Clostridium difficile infections in Medicare beneficiaries. J Am Coll Surg. 2014;218(6):1141‐1147.e1. doi:10.1016/j.jamcollsurg.2014.01.053 [PubMed 24755188]
  62. Craig WA. Interrelationship between pharmacokinetics and pharmacodynamics in determining dosage regimens for broad-spectrum cephalosporins. Diagn Microbiol Infect Dis. 1995;22(1-2):89-96. doi:10.1016/0732-8893(95)00053-d [PubMed 7587056]
  63. Craig WA. Pharmacokinetic/pharmacodynamic parameters: rationale for antibacterial dosing of mice and men. Clin Infect Dis. 1998;26(1):1-10. doi:10.1086/516284 [PubMed 9455502]
  64. Craig WA. Post-antibiotic effects in experimental infection models: relationship to in-vitro phenomena and to treatment of infections in man. J Antimicrob Chemother. 1993;31(suppl D):149-158. doi:10.1093/jac/31.suppl_d.149 [PubMed 8335516]
  65. Dalla Vestra M, Rettore C, Sartore P, et al. Acute septic arthritis: remember gonorrhea. Rheum Int. 2008;29:81-85. [PubMed 18500456]
  66. de Louvois J, Brown EM, Bayston R, Lees PD, Pople LK; Infection in Neurosurgery Working Party of the British Society for Antimicrobial Chemotherapy. The rational use of antibiotics in the treatment of brain abscess: report by the Infection in Neurosurgery Working Party of the British Society for Antimicrobial Chemotherapy. Br J Neurosurg. 2000;14(6):525-530. [PubMed 11272029]
  67. Del Rio M, McCracken GH Jr, Nelson JD, Chrane D, Shelton S. Pharmacokinetics and cerebrospinal fluid bactericidal activity of ceftriaxone in the treatment of pediatric patients with bacterial meningitis. Antimicrob Agents Chemother. 1982;22(4):622-627. doi:10.1128/aac.22.4.622 [PubMed 6295262]
  68. Deshpande A, Pasupuleti V, Thota P, et al. Community-associated Clostridium difficile infection and antibiotics: a meta-analysis. J Antimicrob Chemother. 2013;68(9):1951‐1961. doi:10.1093/jac/dkt129 [PubMed 23620467]
  69. Donnelly PC, Sutich RM, Easton R, Adejumo OA, Lee TA, Logan LK. Ceftriaxone-associated biliary and cardiopulmonary adverse events in neonates: a systematic review of the literature. Paediatr Drugs. 2017;19(1):21‐34. doi:10.1007/s40272-016-0197-x [PubMed 27718120]
  70. Erdem H, Ulu-Kilic A, Kilic S, et al. Efficacy and tolerability of antibiotic combinations in neurobrucellosis: results of the Istanbul study. Antimicrob Agents Chemother. 2012;56(3):1523-1528. doi:10.1128/AAC.05974-11 [PubMed 22155822]
  71. Eyre RC. Acute scrotal pain in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed April 18, 2022.
  72. Fatani DF, Alsanoosi WA, Badawi MA, Thabit AK. Ceftriaxone use in brucellosis: a case series. IDCases. 2019;18:e00633. doi:10.1016/j.idcr.2019.e00633 [PubMed 31534908]
  73. Fernández J, Ruiz del Arbol L, Gómez C, et al. Norfloxacin vs ceftriaxone in the prophylaxis of infections in patients with advanced cirrhosis and hemorrhage. Gastroenterology. 2006;131(4):1049-1056. [PubMed 17030175]
  74. Fernández-Hidalgo N, Almirante B, Gavaldà J, et al. Ampicillin plus ceftriaxone is as effective as ampicillin plus gentamicin for treating enterococcus faecalis infective endocarditis. Clin Infect Dis. 2013;56(9):1261-1268. doi:10.1093/cid/cit052 [PubMed 23392394]
  75. Feurle G, Junga N, Marth T. Efficacy of ceftriaxone or meropenem as initial therapies in Whipple's disease. Gastroenterology. 2010;138:478-486. [PubMed 19879276]
  76. Feurle GE, Moos V, Blacker H, et al. Intravenous ceftriaxone, followed by 12 or three months of oral treatment with trimethoprim sulfamethoxazole in Whipple's disease. J Infect. 2013;66:263-270. [PubMed 23291038]
  77. File TM Jr, Low DE, Eckburg PB, et al; FOCUS 1 investigators. FOCUS 1: a randomized, double-blinded, multicentre, phase III trial of the efficacy and safety of ceftaroline fosamil versus ceftriaxone in community-acquired pneumonia. J Antimicrob Chemother. 2011;66(suppl 3):19-32. doi:10.1093/jac/dkr096 [PubMed 21482566]
  78. File TM Jr. Treatment of community-acquired pneumonia in adults who require hospitalization. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed September 28, 2021.
  79. Friedland IR, McCarroll KA, DiNubile MJ, Woods GL. Ertapenem as initial antimicrobial monotherapy for patients with chronic obstructive pulmonary disease hospitalized with typical community-acquired pneumonia. Pulm Pharmacol Ther. 2004;17(4):199-203. doi:10.1016/j.pupt.2004.03.002 [PubMed 15219264]
  80. Fujitani S, Rowlinson MC, George WL. Penicillin G-resistant viridans group streptococcal endocarditis and interpretation of the American Heart Association's guidelines for the treatment of infective endocarditis. Clin Infect Dis. 2008;46(7):1064-1066. doi:10.1086/529199 [PubMed 18444825]
  81. Garrelts JC, Ast D, LaRocca J, et al. Postinfusion Phlebitis After Intravenous Push versus Intravenous Piggyback Administration of Antimicrobial Agents. Clin Pharm. 1988;7(10):760-765. [PubMed 3233896]
  82. Gehanno P, Nguyen L, Barry B, et al. Eradication by ceftriaxone of Streptococcus pneumoniae isolates with increased resistance to penicillin in cases of acute otitis media. Antimicrob Agents Chemother. 1999;43(1):16-20. doi:10.1128/AAC.43.1.16 [PubMed 9869558]
  83. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2022 report. https://goldcopd.org/wp-content/uploads/2021/12/GOLD-REPORT-2022-v1.1-22Nov2021_WMV.pdf. Accessed September 22, 2022.
  84. Goldenberg DL, Sexton DJ. Septic arthritis in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed January 9, 2019.
  85. Goonetilleke AK, Dev D, Aziz I, Hughes C, Smith MJ, Basran GS. A comparative analysis of pharmacokinetics of ceftriaxone in serum and pleural fluid in humans: a study of once daily administration by intramuscular and intravenous routes. J Antimicrob Chemother. 1996;38(6):969-976. doi:10.1093/jac/38.6.969 [PubMed 9023644]
  86. Grabe M, Bartoletti R, Bjerklund Johansen TE, et al. Guidelines on Urological Infections. 2015. https://uroweb.org/wp-content/uploads/19-Urological-infections_LR2.pdf.
  87. Grégoire M, Dailly E, Le Turnier P, et al. High-dose ceftriaxone for bacterial meningitis and optimization of administration scheme based on nomogram. Antimicrob Agents Chemother. 2019;63(9):e00634-19. doi:10.1128/AAC.00634-19 [PubMed 31235630]
  88. Grubbauer HM, Dornbusch HJ, Dittrich P, et al. Ceftriaxone Monotherapy for Bacterial Meningitis in Children. Chemotherapy. 1990;36(6):441-447. [PubMed 2292206]
  89. Guerrant RL, Van Gilder T, Steiner TS, et al. Practice Guidelines for the Management of Infectious Diarrhea. Clin Infect Dis. 2001;32(3):331-351. [PubMed 11170940]
  90. Guilhaumou R, Benaboud S, Bennis Y, et al. Optimization of the treatment with beta-lactam antibiotics in critically ill patients-guidelines from the French Society of Pharmacology and Therapeutics (Société Française de Pharmacologie et Thérapeutique-SFPT) and the French Society of Anaesthesia and Intensive Care Medicine (Société Française d'Anesthésie et Réanimation-SFAR). Crit Care. 2019;23(1):104. doi:10.1186/s13054-019-2378-9 [PubMed 30925922]
  91. Gupta K, Hooton TM, Naber KG, et al; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103-e120. [PubMed 21292654]
  92. Hagiya H, Miyawaki K, Yamamoto N, et al. Ceftriaxone-induced neurotoxicity in a patient after pancreas-kidney transplantation. Intern Med. 2017;56(22):3103-3107. doi:10.2169/internalmedicine.8774-16 [PubMed 28943562]
  93. Halperin JJ, Shapiro ED, Logigian E, et al. Practice Parameter: Treatment of Nervous System Lyme Disease (an Evidence-Based Review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2007;69(1):91-102. [PubMed 17522387]
  94. Hansel K, Bellini V, Bianchi L, Brozzi J, Stingeni L. Drug reaction with eosinophilia and systemic symptoms from ceftriaxone confirmed by positive patch test: An immunohistochemical study. J Allergy Clin Immunol Pract. 2017;5(3):808‐810. doi:10.1016/j.jaip.2016.10.009 [PubMed 27923648]
  95. Harwood MI, Womack J, Kaptur R. Primary meningococcal arthritis. J Amer Board Fam Med. 2008;21:66-69. [PubMed 18178705]
  96. Hedge DD, Strain JD, Heins JR, Farver DK. New advances in the treatment of Clostridium difficile infection (CDI). Ther Clin Risk Manag. 2008;4(5):949‐964. doi:10.2147/tcrm.s3145 [PubMed 19209277]
  97. Heintz BH, Matzke GR, Dager WE. Antimicrobial dosing concepts and recommendations for critically ill adult patients receiving continuous renal replacement therapy or intermittent hemodialysis. Pharmacotherapy. 2009;29(5):562-77. doi:10.1592/phco.29.5.562 [PubMed 19397464]
  98. Hensgens MP, Goorhuis A, Dekkers OM, Kuijper EJ. Time interval of increased risk for Clostridium difficile infection after exposure to antibiotics. J Antimicrob Chemother. 2012;67(3):742‐748. doi:10.1093/jac/dkr508 [PubMed 22146873]
  99. Hicks CB, Clement M. Syphilis: treatment and monitoring. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed February 22, 2022.
  100. Hohmann EL. Nontyphoidal Salmonella: gastrointestinal infection and carriage. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed June 27, 2022a.
  101. Hohmann EL. Nontyphoidal Salmonella bacteremia. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed April 10, 2019b.
  102. Hooton TM, Gupta K. Acute complicated urinary tract infection (including pyelonephritis) in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed March 20, 2021.
  103. Hryciw BN, Wright CP, Tan K. Rat bite fever on Vancouver Island: 2010-2016. CanCommun Dis Rep. 2018;44(9):215-219. doi:10.14745/ccdr.v44i09a05 [PubMed 31015812]
  104. Hu L. Treatment of Lyme disease. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed September 29, 2021.
  105. Ito S. Drug therapy for breast-feeding women. N Engl J Med. 2000;343(2):118-126. [PubMed 10891521]
  106. Joos B, Luethy R, Muehlen E, Siegenthaler W. Variability of ceftriaxone pharmacokinetics in hospitalized patients with severe infections. Am J Med. 1984;77(4C):59-62. [PubMed 6093521]
  107. Kafetzis DA, Brater DC, Fanourgakis JE, Voyatzis J, Georgakopoulos P. Ceftriaxone distribution between maternal blood and fetal blood and tissues at parturition and between blood and milk postpartum. Antimicrob Agents Chemother. 1983;23(6):870-873. [PubMed 6311089]
  108. Karchmer AW, Chu VH. Antimicrobial therapy of prosthetic valve endocarditis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed November 24, 2020.
  109. Kawakami Y, Katayama T, Kishida M, Oda W, Inoue Y. A case of streptobacillus moniliformis infection with cutaneous leukocytoclastic vasculitis. Acta MedOkayama. 2016;70(5):377-381. doi:10.18926/AMO/54596 [PubMed 27777430]
  110. Kim KB, Kim SM, Park W, Kim JS, Kwon SK, Kim HY. Ceftriaxone-induced neurotoxicity: case report, pharmacokinetic considerations, and literature review. J Korean Med Sci. 2012;27(9):1120-1123. doi:10.3346/jkms.2012.27.9.1120 [PubMed 22969263]
  111. Kimberlin DW, Brady MT, Jackson MA, Long SS, eds; Committee on Infectious Diseases; American Academy of Pediatrics. Red Book: 2015 Report of the Committee on Infectious Diseases. 30th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2015.
  112. King KY. Rat bite fever. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed June 27, 2022.
  113. Kingston M, French P, Higgins S, et al. UK national guidelines on the management of syphilis 2015. Int J STD AIDS. 2016;27(6):421-446. doi:10.1177/0956462415624059 [PubMed 26721608]
  114. Klausner JD. Disseminated gonococcal infection. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed January 11, 2021.
  115. Klein JO. Review of consensus reports on management of acute otitis media. Pediatr Infect Dis J. 1999;18(12):1152-1155. doi:10.1097/00006454-199912000-00031 [PubMed 10608648]
  116. Lam A, Randhawa I, Klaustermeyer W. Cephalosporin induced toxic epidermal necrolysis and subsequent penicillin drug exanthem. Allergol Int. 2008;57(3):281‐284. doi:10.2332/allergolint.C-07-55 [PubMed 18566552]
  117. Lambert JS. An overview of tickborne infections in pregnancy and outcomes in the newborn: The need for prospective studies. Front Med (Lausanne). 2020;7:72. doi:10.3389/fmed.2020.00072 [PubMed 32211414]
  118. Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical practice guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 guidelines for the prevention, diagnosis, and treatment of lyme disease. Arthritis Care Res (Hoboken). 2021;73(1):1-9. doi:10.1002/acr.24495 [PubMed 33251700]
  119. Leibovitz E, Piglansky L, Raiz S, Press J, Leiberman A, Dagan R. Bacteriologic and clinical efficacy of one day vs. three day intramuscular ceftriaxone for treatment of nonresponsive acute otitis media in children. Pediatr Infect Dis J. 2000;19(11):1040-1045. doi:10.1097/00006454-200011000-00003 [PubMed 11099083]
  120. Le Pichon JB, Riordan SM, Watchko J, Shapiro SM. The neurological sequelae of neonatal hyperbilirubinemia: definitions, diagnosis and treatment of the Kernicterus Spectrum Disorders (KSDs). Curr Pediatr Rev. 2017;13(3):199‐209. doi:10.2174/1573396313666170815100214 [PubMed 28814249]
  121. Leicht HB, Weinig E, Mayer B, Viebahn J, Geier A, Rau M. Ceftriaxone-induced hemolytic anemia with severe renal failure: a case report and review of literature. BMC Pharmacol Toxicol. 2018;19(1):67. doi:10.1186/s40360-018-0257-7 [PubMed 30359322]
  122. Li N, Zhou X, Yuan J, Chen G, Jiang H, Zhang W. Ceftriaxone and acute renal failure in children. Pediatrics. 2014;133(4):e917‐e922. doi:10.1542/peds.2013-2103 [PubMed 24664092]
  123. Liberopoulos EN, Liamis GL, Elisaf MS. Possible cefotaxime-induced Stevens-Johnson syndrome. Ann Pharmacother. 2003;37(6):812‐814. doi:10.1345/aph.1C453 [PubMed 12773067]
  124. Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media [published correction appears in Pediatrics. 2014;133(2):346-347]. Pediatrics. 2013;131(3):e964-e999. [PubMed 23439909]
  125. Limb CJ, Lustig LR, Durand ML. Acute otitis media in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed September 28, 2021.
  126. Lipsky BA, Berendt AR, Cornia PB, et al. 2012 Infectious Diseases Society of America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infections. Clin Infect Dis. 2012;54(12):e132-e173. [PubMed 22619242]
  127. Liu HY, Han Y, Chen XS, et al. Comparison of efficacy of treatments for early syphilis: a systematic review and network meta-analysis of randomized controlled trials and observational studies. PLoS One. 2017;12(6):e0180001. doi:10.1371/journal.pone.0180001 [PubMed 28658325]
  128. Lossos IS, Lossos A. Hazards of Rapid Administration of Ceftriaxone. Ann Pharmacother. 1994;28(6):807-808. [PubMed 7919578]
  129. Low DE, File TM Jr, Eckburg PB, et al; FOCUS 2 investigators. FOCUS 2: a randomized, double-blinded, multicentre, phase III trial of the efficacy and safety of ceftaroline fosamil versus ceftriaxone in community-acquired pneumonia. J Antimicrob Chemother. 2011;66(suppl 3):iii33-44. doi:10.1093/jac/dkr097 [PubMed 21482568]
  130. Low YM, Leong JL, Tan HK. Paediatric acute epiglottitis re-visited. Singapore Med J. 2003;44(10):539-541. [PubMed 15024460]
  131. Lu X, Wu R, Huang X, Zhang Y. Noncontrast multidetector-row computed tomography scanning for detection of radiolucent calculi in acute renal insufficiency caused by bilateral ureteral obstruction of ceftriaxone crystals. J Xray Sci Technol. 2012;20(1):11‐16. doi:10.3233/XST-2012-0315 [PubMed 22398584]
  132. Marra CM, Boutin P, McArthur JC, et al. A pilot study evaluating ceftriaxone and penicillin G as treatment agents for neurosyphilis in human immunodeficiency virus-infected individuals. Clin Infect Dis. 2000;30(3):540-544. doi:10.1086/313725 [PubMed 10722441]
  133. Martin E, Koup JR, Paravicini U, et al. Pharmacokinetics of Ceftriaxone in Neonates and Infants With Meningitis. J Pediatr. 1984;105(3):475-481. [PubMed 6088747]
  134. Matthews C, Ausman S. Rat-bite fever: taking the bite out of a textbook case of Streptobacillus moniliformis blood stream infection. IDCases. 2021;25:e01199. doi:10.1016/j.idcr.2021.e01199 [PubMed 34189044]
  135. Mazuski JE, Tessier JM, May AK, et al. The Surgical Infection Society revised guidelines on the management of intra-abdominal infection. Surg Infect (Larchmt). 2017;18(1):1-76. doi:10.1089/sur.2016.261 [PubMed 28085573]
  136. McCann A, Alvi SA, Newman J, et al. Atypical form of cervicofacial actinomycosis involving the skull base and temporal bone. Ann Otol Rhinol Laryngol. 2019;128(2):152-156. doi:10.1177/0003489418808541 [PubMed 30371104]
  137. McCracken GH Jr, Siegel JD, Threlkeld N, Thomas M. Ceftriaxone pharmacokinetics in newborn infants. Antimicrob Agents Chemother. 1983;23(2):341-343. doi:10.1128/aac.23.2.341 [PubMed 6301369]
  138. McDonald LC, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018;66(7):e1‐e48. doi:10.1093/cid/cix1085 [PubMed 29462280]
  139. Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. an official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45-e67. doi:10.1164/rccm.201908-1581ST [PubMed 31573350]
  140. Meyers RS, Thackray J, Matson KL, et al. Key Potentially Inappropriate Drugs in Pediatrics: The KIDs List. J Pediatr Pharmacol Ther. 2020;25(3):175-191. [PubMed 32265601]
  141. Moehring R, Anderson DJ. Gram-negative bacillary bacteremia in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed February 4, 2019.
  142. National Institute for Health and Care Excellence (NICE). Drug allergy: diagnosis and management. Clinical guideline [CG183]. September 3, 2014. https://www.nice.org.uk/guidance/cg183. Accessed May 5, 2020.
  143. Neuman G, Boodhan S, Wurman I, et al. Ceftriaxone-induced immune hemolytic anemia. Ann Pharmacother. 2014;48(12):1594‐1604. doi:10.1177/1060028014548310 [PubMed 25163809]
  144. Nicholson SC, Welte T, File TM Jr, et al. A randomised, double-blind trial comparing ceftobiprole medocaril with ceftriaxone with or without linezolid for the treatment of patients with community-acquired pneumonia requiring hospitalisation. Int J Antimicrob Agents. 2012;39(3):240-246. doi:10.1016/j.ijantimicag.2011.11.005 [PubMed 22230331]
  145. Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017;70(2):252-289. doi:10.1016/j.jacc.2017.03.011 [PubMed 28315732]
  146. Northrop MS, Agarwal HS. Ceftriaxone-induced hemolytic anemia: case report and review of literature. J Pediatr Hematol Oncol. 2015;37(1):e63‐e66. doi:10.1097/MPH.0000000000000181 [PubMed 24878619]
  147. Ollivier J, Carrié C, d'Houdain N, et al. Are standard dosing regimens of ceftriaxone adapted for critically ill patients with augmented creatinine clearance? Antimicrob Agents Chemother. 2019;63(3):e02134-18. doi:10.1128/AAC.02134-18 [PubMed 30602511]
  148. Onal ED, Altinbas A, Onal IK, et al. Successful outpatient management of pelvic actinomycosis by ceftriaxone: a report of three cases. Braz J Infect Dis. 2009;13(5):391-393. doi:10.1590/S1413-86702009000500016 [PubMed 20428643]
  149. Osmon DR, Berbari EF, Berendt AR, et al; Infectious Diseases Society of America. Diagnosis and management of prosthetic joint infection: clinical practice guideline by the Infectious Diseases Society of America. Clin Infect Dis. 2013;56(1):e1-e25. doi:10.1093/cid/cis803 [PubMed 23223583]
  150. Osmon DR, Tande AJ. Osteomyelitis in adults: treatment. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed February 25, 2019.
  151. Pacifici GM. Pharmacokinetics of cephalosporins in the neonate: a review. Clinics (Sao Paulo). 2011;66(7):1267‐1274. doi:10.1590/s1807-59322011000700024 [PubMed 21876985]
  152. Patel IH, Sugihara JG, Weinfeld RE, Wong EG, Siemsen AW, Berman SJ. Ceftriaxone pharmacokinetics in patients with various degrees of renal impairment. Antimicrob Agents Chemother. 1984;25(4):438-442. [PubMed 6329080]
  153. Peker E, Cagan E, Dogan M. Ceftriaxone-induced toxic hepatitis. World J Gastroenterol. 2009;15(21):2669-2671. doi:10.3748/wjg.15.2669 [PubMed 19496200]
  154. Pemberton JH. Acute colonic diverticulitis: medical management. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed June 8, 2021.
  155. Pichichero ME, Casey JR. Safe use of selected cephalosporins in penicillin-allergic patients: a meta-analysis. Otolaryngol Head Neck Surg. 2007;136(3):340-347. doi:10.1016/j.otohns.2006.10.007 [PubMed 17321857]
  156. Pollock AA, Tee PE, Patel IH, Spicehandler J, Simberkoff MS, Rahal JJ Jr. Pharmacokinetic characteristics of intravenous ceftriaxone in normal adults. Antimicrob Agents Chemother. 1982;22(5):816-823. doi:10.1128/aac.22.5.816 [PubMed 6295268]
  157. Pongsuttiyakorn S, Kamolvit W, Limsrivanichakorn S, Phothisirisakulwong A, Wangchinda W. Rat bite fever due to Streptobacillus notomytis complicated by meningitis and spondylodiscitis: a case report. BMC Infect Dis. 2021;21(1):1017. doi:10.1186/s12879-021-06715-2 [PubMed 34583654]
  158. Poole S, Nowobilski-Vasilios A, Free F. Intravenous Push Medications in the Home. J Intraven Nurs. 1999;22(4):209-215. [PubMed 10476138]
  159. Popović J, Grujić Z, Sabo A. Influence of pregnancy on ceftriaxone, cefazolin and gentamicin pharmacokinetics in caesarean vs. non-pregnant sectioned women. J Clin Pharm Ther. 2007;32(6):595-602. [PubMed 18021337]
  160. Powell AM, Nyirjesy P. Acute cervicitis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed February 9, 2022.
  161. Powers HR, Nelson JR, Alvarez S, Mendez JC. Neurobrucellosis associated with feral swine hunting in the southern United States. BMJ Case Rep. 2020;13(12):e238216. doi:10.1136/bcr-2020-238216 [PubMed 33370950]
  162. Public Health Agency of Canada (PHAC). Syphilis guide: key information and resources. https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/syphilis.html. Updated December 12, 2021. Accessed April 29, 2022.
  163. Raad J, Peacock JE. Septic arthritis in the adult caused by Streptococcus pneumoniae: a report of 4 cases and review of the literature. Semin Arthritis Rheum. 2004;34:559-569. [PubMed 15505773]
  164. Refer to manufacturer’s labeling.
  165. Richards DM, Heel RC, Brogden RN, et al. Ceftriaxone: A Review of Its Antibacterial Activity, Pharmacological Properties and Therapeutic Use. Drugs. 1984;27(6):469-527. [PubMed 6329638]
  166. Rocephin (ceftriaxone sodium) [prescribing information]. South San Francisco, CA: Genentech; July 2018.
  167. Rodriguez L, Jung HS, Goulet JA, Cicalo A, Machado-Aranda DA, Napolitano LM. Evidence-based protocol for prophylactic antibiotics in open fractures: improved antibiotic stewardship with no increase in infection rates. J Trauma Acute Care Surg. 2014;77(3):400-407. doi:10.1097/TA.0000000000000398 [PubMed 25159242]
  168. Romano A, Gaeta F, Valluzzi RL, et al. IgE-mediated hypersensitivity to cephalosporins: Cross-reactivity and tolerability of alternative cephalosporins. J Allergy Clin Immunol. 2015;136(3):685‐691.e3. doi:10.1016/j.jaci.2015.03.012 [PubMed 25930196]
  169. Romano A, Gaeta F, Valluzzi RL, Maggioletti M, Caruso C, Quaratino D. Cross-reactivity and tolerability of aztreonam and cephalosporins in subjects with a T cell-mediated hypersensitivity to penicillins. J Allergy Clin Immunol. 2016;138(1):179‐186. doi:10.1016/j.jaci.2016.01.025 [PubMed 27016799]
  170. Romano A, Valluzzi RL, Caruso C, Maggioletti M, Quaratino D, Gaeta F. Cross-reactivity and tolerability of cephalosporins in patients with IgE-mediated hypersensitivity to penicillins. J Allergy Clin Immunol Pract. 2018;6(5):1662‐1672. doi:10.1016/j.jaip.2018.01.020 [PubMed 29408440]
  171. Roncon-Albuquerque R Jr, Pires I, Martins R, Real R, Sousa G, von Hafe P. Ceftriaxone-induced acute reversible encephalopathy in a patient treated for a urinary tract infection. Neth J Med. 2009;67(2):72-75. [PubMed 19299850]
  172. Roson B, Carratala J, Tubau F. Usefulness of beta-lactam therapy for community-acquired pneumonia in the era of drug-resistant Streptococcus pneumoniae: a randomized study of amoxicillin-clavulanate and ceftriaxone. Microb Drug Resist. 2001;7(1):85-96. [PubMed 11310807]
  173. Runyon BA; American Association for the Study of Liver Diseases Practice Guidelines Committee. Management of adult patients with ascites due to cirrhosis: update 2012. https://www.aasld.org/sites/default/files/2019-06/AASLDPracticeGuidelineAsciteDuetoCirrhosisUpdate2012Edition4_.pdf. American Association for the Study of Liver Diseases. Published 2013. Accessed May 4, 2021.
  174. Runyon BA. Spontaneous bacterial peritonitis in adults: treatment and prophylaxis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed April 20, 2022.
  175. Salman A, Yucelten D, Akin Cakici O, Kepenekli Kadayifci E. Acute generalized exanthematous pustulosis due to ceftriaxone: Report of a pediatric case with recurrence after positive patch test. Pediatr Dermatol. 2019;36(4):514‐516. doi:10.1111/pde.13838 [PubMed 31050838]
  176. Sawyer RG, Claridge JA, Nathens AB, et al; STOP-IT Trial Investigators. Trial of short-course antimicrobial therapy for intraabdominal infection. N Engl J Med. 2015;372(21):1996-2005. doi:10.1056/NEJMoa1411162 [PubMed 25992746]
  177. Sawyer SM, Johnson PD, Hogg GG, et al. Successful treatment of epiglottitis with two doses of ceftriaxone. Arch Dis Child. 1994;70(2):129-132. [PubMed 8129435]
  178. Schmitt SK. Osteomyelitis associated with open fractures in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 9, 2020.
  179. Segev S, Raz R, Rubinstein E, et al. Double-blind randomized study of 1 g versus 2 g intravenous ceftriaxone daily in the therapy of community-acquired infections. Eur J Clin Microbiol Infect Dis. 1995;14(10):851-855. [PubMed 8605897]
  180. Seña AC, Cohen MS. Treatment of uncomplicated Neisseria gonorrhoeae infections. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed February 22, 2022.
  181. Sethi S, Murphy TF. Management of infection in exacerbations of chronic obstructive pulmonary disease. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed May 16, 2022.
  182. Sexton DJ. Invasive pneumococcal (Streptococcus pneumoniae) infections and bacteremia. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed February 25, 2019a.
  183. Sexton DJ, Sampson JH. Intracranial epidural abscess. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed September 16, 2021.
  184. Sexton DJ, Sampson JH. Spinal epidural abscess. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 7, 2020d.
  185. Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017;65(12):e45-e80. doi:10.1093/cid/cix669 [PubMed 29053792]
  186. Shen X, Liu W, Fang X, et al. Acute kidney injury caused by ceftriaxone-induced urolithiasis in children: a single-institutional experience in diagnosis, treatment and follow-up. Int Urol Nephrol. 2014;46(10):1909‐1914. doi:10.1007/s11255-014-0742-x [PubMed 24879561]
  187. Shiffman ML, Keith FB, Moore EW. Pathogenesis of ceftriaxone-associated biliary sludge. In vitro studies of calcium-ceftriaxone binding and solubility. Gastroenterology. 1990;99(6):1772‐1778. doi:10.1016/0016-5085(90)90486-k [PubMed 2227290]
  188. Simon N, Dussol B, Sampol E, et al. Population pharmacokinetics of ceftriaxone and pharmacodynamic considerations in haemodialysed patients. Clin Pharmacokinet. 2006;45(5):493-501. [PubMed 16640454]
  189. Smith NH, Musher DM, Huang DB, et al. Response of HIV-infected patients with asymptomatic syphilis to intensive intramuscular therapy with ceftriaxone or procaine penicillin. Int J STD AIDS. 2004;15(5):328-332. doi:10.1177/095646240401500511 [PubMed 15117503]
  190. Solomkin JS, Mazuski JE, Bradley JS, et al. Diagnosis and management of complicated intra-abdominal infections in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America [published correction appears in Clin Infect Dis. 2010;50(12):1695]. Clin Infect Dis. 2010;15;50(2):133-164. [PubMed 20034345]
  191. Southwick FS. Treatment and prognosis of bacterial brain abscess. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed June 23, 2022.
  192. Soysal A, Eraşov K, Akpinar I, Bakir M. Biliary precipitation during ceftriaxone therapy: frequency and risk factors. Turk J Pediatr. 2007;49(4):404‐407. [PubMed 18246742]
  193. St. Cyr S, Barbee L, Workowski KA, et al. Update to CDC's treatment guidelines for gonococcal infection, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(50):1911-1916. doi:10.15585/mmwr.mm6950a6 [PubMed 33332296]
  194. Stamm WE, Hooton TM. Management of urinary tract infections in adults. N Engl J Med. 1993;329(18):1328-1334. [PubMed 8413414]
  195. Stephens I, Levine MM. Management of typhoid fever in children. Pediatr Infect Dis J. 2002;21(2):157-158. [PubMed 11840084]
  196. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):147-159. doi:10.1093/cid/ciu296 [PubMed 24947530]
  197. Stevens DL. Invasive group A streptococcal infection and toxic shock syndrome: epidemiology, clinical manifestations, and diagnosis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed February 27, 2019.
  198. Stoeckel K, Koup JR. Pharmacokinetics of ceftriaxone in patients with renal and liver insufficiency and correlations with a physiologic nonlinear protein binding model. Am J Med. 1984;77(4C):26-32. [PubMed 6093514]
  199. Tajerian A, Sofian M, Zarinfar N, Ramezani A. Manifestations, complications, and treatment of neurobrucellosis: a systematic review and meta-analysis. Int J Neurosci. 2022:1-11. doi:10.1080/00207454.2022.2100776 [PubMed 35930502]
  200. Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004;39(9):1267-1284. [PubMed 15494903]
  201. Tunkel AR, Hasbun R, Bhimraj A, et al. 2017 Infectious Diseases Society of America's clinical practice guidelines for healthcare-associated ventriculitis and meningitis. Clin Infect Dis. 2017;64(6):e34-e65. doi:10.1093/cid/ciw861 [PubMed 28203777]
  202. Turnidge JD. The pharmacodynamics of beta-lactams. Clin Infect Dis. 1998;27(1):10-22. doi:10.1086/514622 [PubMed 9675443]
  203. Udy AA, Roberts JA, Boots RJ, Paterson DL, Lipman J. Augmented renal clearance: implications for antibacterial dosing in the critically ill. Clin Pharmacokinet. 2010;49(1):1-16. doi:10.2165/11318140-000000000-00000 [PubMed 20000886]
  204. US Department of Health and Human Services (HHS) Panel on Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf. Accessed April 30, 2020.
  205. US Department of Health and Human Services (HHS) Panel on Opportunistic Infections in Adults and Adolescents With HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. https://clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-opportunistic-infection/whats-new-guidelines. Updated August 18, 2021. Accessed October 5, 2021.
  206. US Department of Health and Human Services (HHS) Panel on Opportunistic Infections in HIV-Exposed and HIV-Infected Children. Guidelines for prevention and treatment of opportunistic infections in HIV-exposed and HIV-infected children. https://clinicalinfo.hiv.gov/en/guidelines/pediatric-opportunistic-infection/whats-new. Updated March 19, 2021. Accessed October 5, 2021.
  207. Vardakas KZ, Trigkidis KK, Boukouvala E, Falagas ME. Clostridium difficile infection following systemic antibiotic administration in randomised controlled trials: a systematic review and meta-analysis. Int J Antimicrob Agents. 2016;48(1):1‐10. doi:10.1016/j.ijantimicag.2016.03.008 [PubMed 27216385]
  208. Varsano I, Volovitz B, Horev Z, et al. Intramuscular ceftriaxone compared with oral amoxicillin-clavulanate for treatment of acute otitis media in children. Eur J Pediatr. 1997;156(11):858-863. doi:10.1007/s004310050731 [PubMed 9392401]
  209. Vollmer CM, Zakko SF, Afdhal NH. Treatment of acute calculous cholecystitis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 6, 2021.
  210. Wadsworth SJ, Suh B. In vitro displacement of bilirubin by antibiotics and 2-hydroxybenzoylglycine in newborns. Antimicrob Agents Chemother. 1988;32(10):1571‐1575. doi:10.1128/aac.32.10.1571 [PubMed 3190184]
  211. Wald ER, Applegate KE, Bordley C, et.al. Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1-18 years. Pediatrics. 2013;132:e262-e280. [PubMed 23796742]
  212. Warady BA, Bakkaloglu S, Newland J, et al. Consensus Guidelines for the Prevention and Treatment of Catheter-Related Infections and Peritonitis in Pediatric Patients Receiving Peritoneal Dialysis: 2012 Update. Perit Dial Int. 2012, 32(suppl 2):S32-S86. [PubMed 22851742]
  213. Watson T, Hickok J, Fraker S, Korwek K, Poland RE, Septimus E. Evaluating the risk factors for hospital-onset Clostridium difficile infections in a large healthcare system. Clin Infect Dis. 2018;66(12):1957-1959. doi: 10.1093/cid/cix1112 [PubMed 29272341]
  214. Weintrob AC, Sexton DJ. Clinical manifestations, diagnosis, and management of diabetic infections of the lower extremities. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed November 24, 2020.
  215. Wells WG, Woods GL, Jiang Q, Gesser RM. Treatment of complicated urinary tract infection in adults: combined analysis of two randomized, double-blind, multicentre trials comparing ertapenem and ceftriaxone followed by appropriate oral therapy. J Antimicrob Chemother. 2004;53(suppl 2):ii67-ii74. doi:10.1093/jac/dkh208 [PubMed 15150185]
  216. Wen SC, Best E, Nourse C. Non-typhoidal Salmonella infections in children: Review of literature and recommendations for management. J Paediatr Child Health. 2017;53(10):936-941. doi:10.1111/jpc.13585 [PubMed 28556448]
  217. Wilson R, Langan C, Ball P, Bateman K, Pypstra R; Gemifloxacin 207 Clinical Study Group. Oral gemifloxacin once daily for 5 days compared with sequential therapy with i.v. ceftriaxone/oral cefuroxime (maximum of 10 days) in the treatment of hospitalized patients with acute exacerbations of chronic bronchitis. Respir Med. 2003;97(3):242-249. [PubMed 12645831]
  218. Wilson W, Taubert KA, Gewitz M, et al; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee; American Heart Association Council on Cardiovascular Disease in the Young; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Cardiovascular Surgery and Anesthesia; Quality of Care and Outcomes Research Interdisciplinary Working Group. Prevention of infective endocarditis: guidelines from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group [published correction appears in Circulation. 2007;116(15):e376-e377]. Circulation. 2007;116(15):1736-1754 [PubMed 17446442]
  219. Wilson WR, Gewitz M, Lockhart PB, et al; American Heart Association Young Hearts Rheumatic Fever, Endocarditis and Kawasaki Disease Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Cardiovascular and Stroke Nursing; and the Council on Quality of Care and Outcomes Research. Prevention of viridans group streptococcal infective endocarditis: a scientific statement from the American Heart Association. Circulation. 2021;143(20):e963-e978. doi:10.1161/CIR.0000000000000969 [PubMed 33853363]
  220. Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1 [PubMed 34292926]
  221. Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015 [published correction appears in MMWR Recomm Rep. 2015;64(33):924]. MMWR Recomm Rep. 2015;64(RR-03):1-137. [PubMed 26042815]
  222. World Health Organization (WHO). Background document: the diagnosis, treatment and prevention of typhoid fever. http://apps.who.int/iris/bitstream/10665/68122/1/WHO_V-B_03.07_eng.pdf. Published May 2003. Accessed February 4, 2015.
  223. World Health Organization (WHO). Breastfeeding and maternal medication, recommendations for drugs in the eleventh WHO model list of essential drugs. 2002. http://www.who.int/maternal_child_adolescent/documents/55732/en/
  224. World Health Organization (WHO). Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1. http://apps.who.int/iris/bitstream/10665/43252/1/924159330X.pdf?ua=1. Published 2005. Accessed May 17, 2019.
  225. World Health Organization (WHO). Guidelines for the Treatment of Neisseria gonorrhoeae. Geneva, Switzerland: World Health Organization; 2016. [PubMed 27512795]
  226. Yahav D, Franceschini E, Koppel F, et al; Bacteremia Duration Study Group. Seven versus fourteen days of antibiotic therapy for uncomplicated Gram-negative bacteremia: a non-inferiority randomized controlled trial. Clin Infect Dis. Published online December 11, 2018. doi:10.1093/cid/ciy1054 [PubMed 30535100]
  227. Yang MS, Kang DY, Seo B, et al. Incidence of cephalosporin-induced anaphylaxis and clinical efficacy of screening intradermal tests with cephalosporins: A large multicenter retrospective cohort study. Allergy. 2018;73(9):1833‐1841. doi:10.1111/all.13435 [PubMed 29517808]
  228. Yogev R, Shulman ST, Chadwick EG, et al. Once Daily Ceftriaxone for Central Nervous System Infections and Other Serious Pediatric Infections. Pediatr Infect Dis. 1986;5(3):298-303. [PubMed 3725639]
  229. Zeng L, Wang C, Jiang M, et al. Safety of ceftriaxone in paediatrics: a systematic review. Arch Dis Child. 2020;archdischild-2019-317950. Published online March 6, 2020. doi:10.1136/archdischild-2019-317950 [PubMed 32144089]
  230. Zhao S, Cheng Y, Liao Y, Zhang Z, Yin X, Shi S. Treatment efficacy and risk factors of neurobrucellosis. Med Sci Monit. 2016;22:1005-1012. doi:10.12659/msm.897947 [PubMed 27018084]
  231. Zheng N, Wang W, Zhang JT, et al. Neurobrucellosis. Int J Neurosci. 2018;128(1):55-62. doi:10.1080/00207454.2017.1363747 [PubMed 28768443]
Topic 13136 Version 448.0