Ceftriaxone

Third-generation Cephalosporin Antibiotic

Generic Name

Ceftriaxone

Drug Class

Beta-lactam antibiotic • Cephalosporin (3rd generation)

Indications

Severe community-acquired and nosocomial infections
Lower and upper respiratory tract infections
Septicemia
Meningitis
Gonococcal infections
Skin and soft tissue infections
Bone and joint infections

Dosage

Adults: 1–2 g IV/IM every 12–24 hours
Severe infections: up to 4 g/day in divided doses
Children: 50–75 mg/kg/day IV/IM in 1–2 divided doses

Note: Adjust dose in severe renal or hepatic impairment.

Route of Administration

Intravenous (IV), Intramuscular (IM)

Mechanism of Action

Ceftriaxone inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, leading to lysis and death. Active against many Gram-positive and Gram-negative bacteria.

Common Adverse Effects

Diarrhea
Nausea, vomiting
Rash
Injection site reactions

Serious Adverse Effects

Anaphylaxis
Severe hypersensitivity reactions
Hematologic abnormalities (neutropenia, thrombocytopenia)
Cholestatic hepatitis (rare)
Clostridioides difficile–associated diarrhea

Contraindications

Hypersensitivity to ceftriaxone or other cephalosporins
Neonates with hyperbilirubinemia (risk of kernicterus)
Concurrent IV calcium in neonates

Precautions

Renal or hepatic impairment (monitor closely)
History of penicillin allergy
Monitor for diarrhea and signs of infection

Drug Interactions

Calcium-containing IV solutions – may form precipitates
Warfarin – may enhance anticoagulant effect
Concurrent aminoglycosides – monitor renal function

Pregnancy & Lactation

Generally considered safe in pregnancy and breastfeeding if used as prescribed.

Patient Counseling

Report rash or signs of allergy immediately
Complete full course even if feeling better
Inform provider if renal or liver disease is present
Seek urgent care for severe diarrhea or jaundice