Instructions for use CEFTRIAXONE

Pharmacodynamics and pharmacokinetics

What is Ceftriaxone?

According to Wikipedia, ceftriaxone is an antibiotic whose bactericidal effect is due to its ability to disrupt the synthesis of peptidoglycan in bacterial cell walls.

Pharmacodynamics

A universal antibacterial agent, the mechanism of action of which is determined by the ability to suppress the synthesis of the bacterial cell wall. The drug exhibits greater resistance to most β-lactamases of gram(+) and gram(-) microorganisms.

Active regarding:

• Gram(+) aerobes - St. aureus (including penicillinase-producing strains) and Epidermidis, Streptococcus (pneumoniae, pyogenes, viridans group);
• Gram(-) aerobes - Enterobacter aerogenes and cloacae, Acinetobacter calcoaceticus, Haemophilus influenzae (including penicillinase-producing strains) and parainfluenzae, Borrelia burgdorferi, Klebsiella spp. (including pneumoniae), Escherichia coli, Moraxella catarrhalis and diplococci of the genus Neisseria (including penicillinase-producing strains), Morganella morganii, Proteus vulgaris and Proteus mirabilis, Neisseria meningitidis, Serratia spp., some strains of Pseudomonas aeruginosa;
• anaerobes - Clostridium spp. (exception: Clostridium difficile), Bacteroides fragilis, Peptostreptococcus spp..

In vitro (clinical significance remains unknown) activity is observed against strains of the following bacteria: Citrobacter diversus and freundii, Salmonella spp. (including against Salmonella typhi), Providencia spp. (including in relation to Providencia rettgeri), Shigella spp.; Bacteroides bivius, Streptococcus agalactiae, Bacteroides melaninogenicus.

Methicillin -resistant Staphylococcus, many strains of Enterococcus (including Str. faecalis) and group D Streptococcus are resistant to cephalosporin antibiotics (including ceftriaxone).

Pharmacokinetics

• bioavailability - 100%;
• T Cmax when Ceftriaxone is administered intravenously - at the end of the infusion, when administered intramuscularly - 2-3 hours;
• connection with plasma proteins - from 83 to 96%;
• T1/2 with intramuscular administration - from 5.8 to 8.7 hours, with intravenous administration - from 4.3 to 15.7 hours (depending on the disease, the patient’s age and the condition of his kidneys).

In adults, the concentration of ceftriaxone in the cerebrospinal fluid when administered 50 mg/kg after 2-24 hours is many times higher than the MIC (minimum inhibitory concentration) for the most common pathogens of meningococcal infection . The drug penetrates well into the cerebrospinal fluid during inflammation of the meninges.

Ceftriaxone is excreted unchanged:

• kidneys - by 33-67% (in newborn babies this figure is 70%);
• with bile into the intestines (where the drug is inactivated) - by 40-50%.

Hemodialysis is ineffective.

Indications for use of Ceftriaxone

The annotation states that the indications for the use of Ceftriaxone are infections caused by bacteria sensitive to the drug. Intravenous infusions and injections of medications are prescribed to treat:

• infections of the abdominal cavity (including empyema of the gallbladder , angiocholitis , peritonitis ), ENT organs and respiratory tract ( empyema of the pleura , pneumonia , bronchitis , lung abscess , etc.), bone and joint tissue, soft tissues and skin, urogenital tract (including pyelonephritis , pyelitis , prostatitis , cystitis , epididymitis );
• epiglottitis;
• infected burns/wounds;
• infectious lesions of the maxillofacial area;
• bacterial septicemia;
• sepsis;
• bacterial endocarditis;
• bacterial meningitis;
• syphilis;
• chancroid;
• tick-borne borreliosis (Lyme disease);
• uncomplicated gonorrhea (including in cases where the disease is caused by microorganisms that secrete penicillinase);
• salmonellosis/salmonella carriage;
• typhoid fever.

The drug is also used for perioperative prophylaxis and for the treatment of immunocompromised patients.

What is Ceftriaxone used for for syphilis?

Although Penicillin is the drug of choice of syphilis , its effectiveness may be limited in some cases.

The use of cephalosporin antibiotics is resorted to as a backup option in case of intolerance to drugs of the penicillin group.

The valuable properties of the drug are:

• the presence in its composition of chemical substances that have the ability to suppress the formation of cell membranes and mucopeptide synthesis in the walls of bacterial cells;
• the ability to quickly penetrate organs, fluids and tissues of the body and, in particular, into the cerebrospinal fluid, which in patients with syphilis undergoes many specific changes;
• Possibility of use for the treatment of pregnant women.

The medicine is most effective in cases where the causative agent of the disease is Treponema pallidum, since the distinctive feature of Ceftriaxone is its high treponemocidal activity. The positive effect is especially pronounced with intramuscular administration of the drug.

Treatment of syphilis with the use of the drug gives good results not only in the early stages of the disease, but also in advanced cases: with neurosyphilis , as well as with secondary and latent syphilis.

Since T1/2 of Ceftriaxone is approximately 8 hours, the drug can be used equally successfully in both inpatient and outpatient treatment regimens. It is enough to administer the drug to the patient once a day.

For preventive treatment, the drug is administered over 5 days, for primary syphilis - a 10-day course, early latent and secondary syphilis are treated within 3 weeks.

For non-advanced forms of neurosyphilis, the patient is administered a single dose of 1-2 g of Ceftriaxone for 20 days; in the later stages of the disease, the drug is administered at a dose of 1 g/day. for 3 weeks, after which an interval of 14 days is maintained and treatment with a similar dosage is carried out for 10 days.

For acute generalized meningitis and syphilitic meningoencephalitis, the dose is increased to 5 g/day.

Ceftriaxone injections: why is the drug prescribed for angina in adults and children?

Despite the fact that the antibiotic is effective for various lesions of the nasopharynx (including sore throat and sinusitis ), it is, as a rule, rarely used as a drug of choice, especially in pediatrics.

For angina, the medicine can be administered through a dropper into a vein or in the form of regular injections into the muscle. However, in the vast majority of cases, the patient is prescribed intramuscular injections. The solution is prepared immediately before use. The finished mixture remains stable at room temperature for 6 hours after preparation.

For children with angina, Ceftriaxone is prescribed in exceptional cases when acute angina is complicated by severe suppuration and inflammation.

The appropriate dosage is determined by the attending physician.

During pregnancy, the drug is prescribed in cases where penicillin antibiotics are not effective. Although the medicine crosses the placental barrier, it does not have a significant effect on the health and development of the fetus.

Treatment of sinusitis with Ceftriaxone

For sinusitis, antibacterial agents are first-line drugs. Completely penetrating the blood, Ceftriaxone is retained at the site of inflammation in the required concentrations.

As a rule, the medicine is prescribed in combination with mucolytics , vasoconstrictors , etc.

How to inject the drug for sinusitis? Typically, the patient is prescribed Ceftriaxone to be injected into the muscle twice a day, 0.5-1 g. Before injection, the powder is mixed with Lidocaine (it is preferable to use a one percent solution) or d/i water.

Treatment lasts at least 1 week.

What helps with ceftriaxone injections, indications and contraindications

The drug is presented as a yellowish or white fine-crystalline powder. The composition includes ceftriaxone, which belongs to the class of cephalosporins. The medicine is used for injections and infusion therapy; the bottle contains 0.25, 0.5, 1 and 2 g of the active ingredient. The medication is considered a universal antibacterial agent, active against gram-positive and gram-negative microorganisms.

The instructions indicate the following indications for the use of Ceftriaxone:

• inflammation of the peritoneum, angiocholitis, accumulation of pus in the cavity of the gallbladder;
• respiratory diseases - bronchitis, abscess, pneumonia, purulent pleurisy;
• lesions of bone, joint, soft tissues and dermis, genitourinary department - with pyelonephritis, pyelitis, cystitis, prostatitis, epididymitis;
• infections of burn and wound surfaces;
• sepsis, bacterial septicemia, meningitis;
• syphilis, chancroid, tick-borne borreliosis;
• salmonellosis, uncomplicated gonorrhea, typhoid fever.

The medicine is used to prevent secondary infections in the postoperative period and to treat people with a weakened immune system.

Ceftriaxone is contraindicated in patients:

• with allergic reactions to the component composition;
• hyperbilirubinemia, prematurity (for newborns);
• liver or kidney failure;
• enteritis, colitis associated with antibacterial therapy.

The medication is not used during pregnancy and breastfeeding.

Contraindications

Ceftriaxone is not prescribed in case of known hypersensitivity to cephalosporin antibiotics or auxiliary components of the drug.

Relative contraindications:

• the neonatal period if the child has hyperbilirubinemia ;
• prematurity;
• renal/liver failure;
• enteritis , UC or colitis associated with the use of antibacterial agents;
• pregnancy;
• lactation.

Side effects of Ceftriaxone

Side effects of the drug appear as:

• hypersensitivity reactions: eosinophilia , fever, itching, urticaria edema , skin rash, multiforme (in some cases malignant) exudative erythema , serum sickness , anaphylactic shock , chills;
• headache and dizziness;
• oliguria;
• dysfunction of the digestive organs: nausea, vomiting, flatulence , taste disturbance, stomatitis , diarrhea , glossitis , formation of sludge in the gallbladder and pseudocholelithiasis , pseudomembranous enterocolitis , dysbacteriosis , candidomycosis and other superinfections;
• hematopoiesis disorders: anemia (including hemolytic ), lymphopenia , leukopenia, neutropenia, thrombocytopenia, granulocytopenia , thrombocytosis and leukocytosis , hematuria , basophilia , nosebleeds).

If the medicine is administered intravenously, inflammation of the venous wall, as well as pain along the vein, is possible. The injection of the drug into the muscle is accompanied by pain at the injection site.

Ceftriaxone (injections and IV infusion) may also affect laboratory parameters. The patient's prothrombin time decreases (or increases), the activity of alkaline phosphatase and liver transaminases increases, as well as the concentration of urea, hypercreatininemia , hyperbilirubinemia , and glycosuria .

Reviews of the side effects of Ceftriaxone allow us to conclude that with intramuscular administration of the drug, almost 100% of patients complain of severe pain from the injection, some report muscle pain, dizziness, chills, weakness, itching and rash.

The injections are easiest to tolerate if you dilute the powder with an anesthetic. In this case, it is necessary to do a test both for the drug itself and for the painkiller.

Instructions for use of Ceftriaxone (Method and dosage)

How to dilute Ceftriaxone for injection?

The manufacturer's instructions, as well as the Vidal reference book, indicate that the drug can be injected into a vein or into a muscle.

Dosage for adults and children over 12 years of age: 1-2 g/day. The antibiotic is administered once or once every 12 hours at half the dose.

In particularly serious cases, as well as if the infection is caused by a pathogen moderately sensitive to Ceftriaxone, the dose is increased to 4 g/day.

For gonorrhea , a single injection of 250 mg of the drug into the muscle is recommended.

For preventive purposes, before an infected or suspected infected operation, depending on the degree of danger of infectious complications, the patient should be administered a single dose of 1-2 g of Ceftriaxone 0.5-1.5 hours before surgery.

For children in the first 2 weeks of life, the medicine is administered 1 time per day. The dose is calculated using the formula 20-50 mg/kg/day. The highest dose is 50 mg/kg (which is due to the underdevelopment of the enzyme system).

The optimal dosage for children under 12 years of age (including infants) is also selected depending on weight. The daily dose varies from 20 to 75 mg/kg. For children weighing more than 50 kg, Ceftriaxone is prescribed in the same dose as for adults.

Doses greater than 50 mg/kg should be administered as an intravenous infusion over at least 30 minutes.

For bacterial meningitis, treatment begins with a single dose of 100 mg/kg/day. The highest dose is 4 g. As soon as the pathogen is isolated and its sensitivity to the drug is determined, the dose is reduced.

Reviews about the drug (in particular, about its use in children) allow us to conclude that the drug is very effective and affordable, but its significant drawback is severe pain at the injection site. As for side effects, according to the patients themselves, there are no more of them than with any other antibiotic.

How many days to inject the drug?

The duration of treatment depends on what pathogenic microflora causes the disease, as well as on the characteristics of the clinical picture. If the causative agent is Gram (-) diplococci of the genus Neisseria, the best results can be achieved in 4 days, if enterobacteria are sensitive to the drug - in 10-14 days.

Ceftriaxone injections, instructions for use. How to dilute the drug?

Lidocaine solution (1 or 2%) or water for injection (d/i).

When using water d/i, it should be taken into account that intramuscular injections of the drug are very painful, so if the solvent is water, there will be discomfort both during the injection and for some time after it.

Water for diluting the powder is usually taken in cases where the use of Lidocaine is impossible due to the patient being allergic to it.

The best option is a one percent solution of Lidocaine. It is better to use water as an adjuvant when diluting the drug with Lidocaine 2%.

Is it possible to dilute Novocaine with Ceftriaxone?

Novocaine , when used to dilute the drug, reduces the activity of the antibiotic, while at the same time increasing the likelihood of the patient developing anaphylactic shock .

Based on the reviews of the patients themselves, they note that Lidocaine is better than Novocaine in relieving pain when Ceftriaxone is administered.

In addition, the use of a non-freshly prepared solution of Ceftriaxone with Novocaine increases pain during injection (the solution remains stable for 6 hours after preparation).

How to dilute Ceftriaxone with Novocaine?

If Novocain is used as a solvent, it is taken in a volume of 5 ml per 1 g of the drug. If you take a smaller amount of Novocaine, the powder may not completely dissolve, and the syringe needle will become clogged with lumps of medicine.

Dilution with Lidocaine 1%

For injection into the muscle, 0.5 g of the drug is dissolved in 2 ml of a one percent solution of Lidocaine (the contents of one ampoule); For 1 g of the drug take 3.6 ml of solvent.

The dosage of 0.25 g is diluted in the same way as 0.5 g, that is, with the contents of 1 ampoule of 1% Lidocaine. After this, the finished solution is drawn into different syringes, half the volume in each.

The medicine is injected deep into the gluteal muscle (no more than 1 g in each buttock).

The drug diluted with Lidocaine is not intended for intravenous administration. It is allowed to be injected strictly into the muscle.

How to dilute Ceftriaxone injections with Lidocaine 2%?

To dilute 1 g of the drug, take 1.8 ml of water and two percent Lidocaine. To dilute 0.5 g of the drug, also mix 1.8 ml of Lidocaine with 1.8 ml of water, but only half of the resulting solution (1.8 ml) is used for dissolution. To dilute 0.25 g of the drug, take 0.9 ml of a solvent prepared in a similar way.

How to dilute Ceftriaxone for intramuscular administration in children?

This method of intramuscular injection is practically not used in pediatric practice, since Ceftriaxone with Novocaine can cause severe anaphylactic shock in a child, and in combination with Lidocaine, it can contribute to the occurrence of convulsions and disruption of the heart.

For this reason, the optimal solvent when using the drug in children is ordinary water. The impossibility of using painkillers in childhood requires an even slower and more careful administration of the medicine in order to reduce pain during the injection.

Dilution for intravenous administration

For intravenous administration, 1 g of the drug is dissolved in 10 ml of distilled water (sterile). The drug is administered slowly over 2-4 minutes.

Dilution for intravenous infusion

When carrying out infusion therapy, the drug is administered for at least half an hour. To prepare a solution, 2 g of powder is diluted in 40 ml of a Ca-free solution: dextrose (5 or 10%), NaCl (0.9%), fructose (5%).

Additionally

Ceftriaxone is intended exclusively for parenteral administration: manufacturers do not produce tablets and suspensions due to the fact that the antibiotic, when in contact with body tissues, is highly active and severely irritates them.

Doses for animals

The dosage for cats and dogs is selected taking into account the body weight of the animal. As a rule, it is 30-50 mg/kg.

If a 0.5 g bottle is used, 1 ml of two percent Lidocaine and 1 ml of water d/i (or 2 ml of Lidocaine 1%) should be added to it. After vigorously shaking the medicine until the lumps are completely dissolved, it is drawn into a syringe and injected into the muscle or under the skin of the sick animal.

The dosage for a cat (Ceftriaxone 0.5 g is usually used for small animals - cats, kittens, etc.), if the doctor prescribed 40 mg of Ceftriaxone per 1 kg of weight, is 0.16 ml/kg.

For dogs (and other large animals), take bottles of 1 g. The solvent is taken in a volume of 4 ml (2 ml Lidocaine 2% + 2 ml water for injection). For a dog weighing 10 kg, if the dose is 40 mg/kg, you need to administer 1.6 ml of the prepared solution.

If it is necessary to administer Ceftriaxone intravenously through a catheter, sterile distilled water is used for dilution.

Dosage and use in veterinary medicine

According to the instructions for use for veterinary medicine, the dry powder in the bottle should be diluted with 5-10 ml of solvent and administered at intervals of 12-24 hours. As a solvent, you can use isotonic sodium chloride solution, novocaine solution, lidocaine solution. Intramuscular injections of the drug into animals are quite painful.

Therefore, for intramuscular use it is preferable to use solutions of novocaine or lidocaine. Potassium-containing solutions (Ringer's solution, Hratman's solution, Ringer-Lock solution, Trisol, ionosteril) cannot be used as a solvent. Glucose is also not used to dissolve the drug.

The drug can be administered to animals intramuscularly or intravenously.

• Large animals (cattle and horses): ceftriaxone dose from 15 to 50 mg/kg body weight 1-2 times a day for 5-7 days.
• Calves, sheep and goats: dose 15 to 50 mg/kg body weight 1-2 times daily for 5-7 days.
• Dogs: 15 to 50 mg/kg body weight 1-2 times daily for 5-7 days.
• Cats: 25 to 50 mg/kg body weight 1-2 times daily for 5-7 days.

Interaction

In one volume, it is pharmaceutically incompatible with other antimicrobial agents.

By suppressing intestinal microflora, it prevents the formation of vitamin K . For this reason, the use of the drug in combination with drugs that reduce platelet aggregation (sulfinpyrazone, NSAIDs) may provoke bleeding.

The same feature of Ceftriaxone enhances the effect of anticoagulants when used together.

In combination with loop diuretics, the risk of nephrotoxicity increases.

Drug interactions Ceftriaxone

Ceftriaxone should not be added to solutions containing calcium (Hartmann and Ringer solutions). Ceftriaxone is incompatible with amsacrine, vancomycin, fluconazole and aminoglycosides. There is no evidence that ceftriaxone increases the toxicity of aminoglycosides. An antagonistic interaction between chloramphenicol and ceftriaxone has been established. In combination with aminoglycosides, ceftriaxone has a synergistic effect, which is especially important in the treatment of severe infections caused by Pseudomonas aeruginosa .

special instructions

The drug is used in a hospital setting. In patients who are on hemodialysis, as well as with simultaneous severe hepatic and renal failure, plasma concentrations of Ceftriaxone should be kept under control.

With long-term treatment, regular monitoring of the peripheral blood picture and indicators characterizing the function of the kidneys and liver is required.

Sometimes (rarely) an ultrasound of the gallbladder may show shadows that indicate the presence of sediment. The darkening disappears after stopping the course of treatment.

vitamin K in addition to Ceftriaxone .

If there is an imbalance of water and electrolytes, as well as arterial hypertension , the level of sodium in the blood plasma should be monitored. If the treatment is long-term, the patient is advised to undergo a general blood test.

Like other cephalosporins, the drug has the ability to displace bilirubin , and therefore it is used with caution in newborns with hyperbilirubinemia (and, in particular, in premature infants).

The drug does not affect the speed of neuromuscular conduction.

Ceftriaxone ()

Hypersensitivity reactions. As with other beta-lactam antibiotics, severe hypersensitivity reactions, including fatal ones, have been reported (see section "Post-marketing surveillance"). If a severe hypersensitivity reaction develops, ceftriaxone therapy should be discontinued immediately and appropriate emergency treatment measures taken. Before starting therapy with ceftriaxone, it is necessary to determine whether the patient has had hypersensitivity reactions to ceftriaxone, cephalosporins or severe hypersensitivity reactions to other beta-lactam antibiotics (penicillins, monobactams and carbapenems). Caution should be exercised when using ceftriaxone in patients with a history of mild hypersensitivity reactions to other beta-lactam antibiotics (penicillins, monobactams and carbapenems). Severe cutaneous adverse reactions (Stevens-Johnson syndrome or Lyell's syndrome/toxic epidermal necrolysis) and drug reaction with eosinophilia and systemic symptoms (DRESS), which may be life-threatening or fatal, have been reported in association with ceftriaxone therapy; however, the frequency of these events is unknown.

The sodium content of 250 mg and 500 mg of ceftriaxone contains 0.9 mmol and 1.8 mmol sodium, respectively, which should be taken into account by patients on a restricted diet.

Hemolytic anemia. As with the use of other cephalosporins, the development of autoimmune hemolytic anemia is possible during treatment with ceftriaxone. Cases of severe hemolytic anemia have been reported in adults and children, including deaths. If anemia develops in a patient being treated with ceftriaxone, the diagnosis of cephalosporin-associated anemia cannot be excluded and treatment must be discontinued until the cause is determined.

Diarrhea caused by Clostridium difficile. As with most other antibacterial drugs, cases of diarrhea caused by Clostridium difficile (C. difficile) of varying severity have been reported during treatment with ceftriaxone, ranging from mild diarrhea to fatal colitis. Treatment with antibacterial drugs suppresses the normal microflora of the colon and provokes the growth of C. difficile. In turn, C. difficile produces toxins A and B, which are factors in the pathogenesis of diarrhea caused by C. difficile. Toxin-overproducing strains of C. difficile are infectious agents with a high risk of morbidity and mortality due to possible resistance to antimicrobial therapy, and treatment may require colectomy. It is important to be aware of the possibility of developing C. difficile diarrhea in all patients with diarrhea after antibiotic therapy. A thorough history taking is necessary, because There have been cases of diarrhea caused by C. difficile occurring more than 2 months after antibiotic therapy. If C. difficile diarrhea is suspected or confirmed, current non-C. difficile antibiotic therapy may need to be discontinued. In accordance with clinical indications, appropriate treatment should be prescribed with the administration of fluids and electrolytes, proteins, antibiotic therapy for C. difficile, and surgical treatment. Do not use medications that inhibit intestinal motility.

Superinfections. As with treatment with other antibacterial drugs, superinfections may develop.

Formation of precipitates of ceftriaxone calcium salt. After using ceftriaxone, usually in doses exceeding the standard recommended (1 g per day or more), ultrasound examination of the gallbladder revealed precipitates of the calcium salt of ceftriaxone, the formation of which is most likely in pediatric patients. Precipitates rarely cause any symptoms and disappear after ceftriaxone therapy is stopped. If these phenomena are accompanied by clinical symptoms, conservative non-surgical treatment is recommended, and the decision to discontinue the drug is left to the discretion of the attending physician and should be based on an individual assessment of benefit and risk. Although there is evidence of the formation of intravascular precipitates only in neonates when using ceftriaxone and calcium-containing infusion solutions or any other calcium-containing drugs, ceftriaxone should not be mixed or prescribed to children and adult patients simultaneously with calcium-containing infusion solutions, even using different venous approaches (see sections " Contraindications", "Interaction with other drugs", subsection "Post-registration surveillance").

Pancreatitis. Rare cases of pancreatitis, possibly due to bile duct obstruction, have been described in patients receiving ceftriaxone. Most of these patients had preexisting risk factors for biliary congestion, such as prior therapy, severe illness, and total parenteral nutrition. At the same time, it is impossible to exclude a trigger or cofactor role in the development of pancreatitis of precipitates formed under the influence of ceftriaxone in the biliary tract.

Use in children. The safety and effectiveness of ceftriaxone in neonates, infants, and young children have been determined at the dosages described in the Dosage and Administration section. Studies have shown that, like other cephalosporins, ceftriaxone can displace bilirubin from binding to serum albumin. Ceftriaxone should not be used in newborns, especially premature infants, who are at risk of developing biliary encephalopathy (see section "Contraindications").

Blood test monitoring. During long-term treatment, a complete blood count should be performed regularly.

Jarisch-Herxheimer reaction (JHR). Some patients with spirochete infection may develop a Jarisch-Herxheimer reaction (JHR) soon after starting ceftriaxone therapy. JHR is usually a self-limiting condition or can be controlled with symptomatic treatment. Antibiotic therapy should not be stopped if this reaction occurs.

Effect on laboratory test results. When using ceftriaxone, patients may experience false-positive Coombs test results. Like other antibiotics, ceftriaxone may give a false-positive test result for galactosemia. False-positive results can also be obtained when determining glucose in urine using non-enzymatic methods; therefore, during therapy with ceftriaxone, glucosuria, if necessary, should be determined only by the enzymatic method. Ceftriaxone may cause an unreliable decrease in blood glucose readings obtained with some blood glucose monitoring devices (see instructions in the instructions for use of your device). If necessary, alternative methods for determining blood glucose should be used.

Ceftriaxone analogues, what can replace the drug?

Level 4 ATC code matches:
Cephosin

Lendatsin

Medakson

Loprax

Cefixime

Lorakson

Sulperazon

Cefoperazone

Rocephin

Tsedex

Fortum

Ceftazidime

Cefotaxime

Cefix

Ceforal Solutab

Pantsef

Claforan

Cefodox

Suprax Solutab

Analogues of Ceftriaxone in injections:

• Ceftriaxone-LEKSVM (Kabi, Jodas, KMP, Promed, Vial, Elfa)
• Ceftriabol
• Tsefson
• Cefaxon
• Torotsef
• Hizon
• Cephogram
• Medakson
• Lorakson
• Ifitsef

Analogues in tablets:

• Pantsef
• Suprax Solutab
• Ceforal Solutab
• Cefpotec
• Spectraceph

Ceftriaxone or Cefazolin - which is better?

Both drugs belong to the cephalosporin group, but Ceftriaxone is a third-generation antibiotic, and Cefazolin is a first-generation drug.

An important feature of first generation cephalosporin antibiotics is that they are not effective against listeria and enterococci, have a narrow spectrum of action and a low level of activity against gram(-) bacteria.

Cefazolin is used mainly in surgery for perioperative prophylaxis, as well as for the treatment of soft tissue and skin infections.

Its prescription for the treatment of infections of the genitourinary system and respiratory tract cannot be considered as justified, which is associated with a narrow spectrum of antimicrobial activity and high resistance to it among potential pathogens.

Which is better: Ceftriaxone or Cefotaxime?

Cefotaxime and Ceftriaxone are the basic antimicrobial agents of the third generation cephalosporin group. The drugs are almost identical in their bactericidal properties.

Pharmacological properties of the drug Ceftriaxone

Semisynthetic cephalosporin antibiotic of the third generation. Highly active against most gram-positive and gram-negative, as well as anaerobic bacteria. Acts bactericidal. The mechanism of action is associated with the suppression of the synthesis of bacterial membrane components. Resistant to the hydrolytic action of most β-lactamases and active against strains resistant to other cephalosporins. It is quickly absorbed after intramuscular administration and reaches a high concentration in the blood serum within 24 hours. It penetrates well into all tissues and CSF, especially with meningitis. The half-life is 8 hours. Thanks to this, with a single use of ceftriaxone during the day, a concentration of the antibiotic is achieved that exceeds the MIC for most pathogens. About 60% of ceftriaxone is excreted in active form in the urine, 40% in bile.

Ceftriaxone during pregnancy and breastfeeding

The drug is contraindicated in the first trimester of pregnancy. If it is necessary to prescribe to a nursing woman, the child should be switched to formula.

Reviews of Ceftriaxone during pregnancy confirm that the drug is indeed a very powerful and very effective antibacterial agent that can not only cure the underlying disease, but also prevent the development of its complications.

Considering that the drug (like other antibiotics) has side effects, it is prescribed only in cases where potential complications of the disease could be more harmful than the use of the drug (in particular, for infections of the urogenital tract, to which pregnant women are very susceptible).

Reviews of Ceftriaxone

Ceftriaxone is a potent antibiotic (reviews from doctors confirm this fact), which helps cure the disease in a short time and with a minimum number of side effects. It is allowed to be used for children and during pregnancy (exception - 1st trimester).

According to the patients themselves, the main disadvantage of the drug is that the injections are very painful.

In reviews of Ceftriaxone injections for children, to facilitate the procedure, mothers (on the advice of the attending physician) are recommended to use Emla , which is a local anesthetic. It is applied in about half an hour to the intended injection site.

Ceftriaxone price, where to buy

How much does an antibiotic cost in Russian pharmacies? The price of Ceftriaxone injections varies depending on which company produces it, as well as the number of ampoules in each package and the concentration of the active substance in the vial.

The price of Ceftriaxone in Russian pharmacies is from 30 rubles per bottle.

The price of Ceftriaxone in Ukraine is from 15 UAH. per bottle of 1 g. At the same time, there is no significant difference between prices in the capital's pharmacies and pharmacies in other cities (Kharkov, Dnepropetrovsk, Lvov).

It is impossible to buy Ceftriaxone tablets. The drug is intended exclusively for parenteral administration.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Ceftriaxone-AKOS por.
  d/prep. solutions for intravenous and intramuscular injection. 1g fl. No. 50 for hospitals Sintez OJSC RUB 1,761 order
• Ceftriaxone por. for preg sol. for i.v. and i.m. input. fl. 1000 mgRUP Belmedpreparaty

  54 RUR order

• Ceftriaxone powder for injection solution for IV and IM injection. 1g bottle of Rapharma JSC

  46 RUR order

• Ceftriaxone powder prig solution for intravenous and intramuscular injection. fl. 1gPAO Biosintez

  44 RUR order

• Ceftriaxone powder for injection solution 1g bottle JSC Pharmaceutical company LEKKO

  44 RUR order

Pharmacy Dialogue

• Ceftriaxone (vial 1g IM, IV)Biokhimik JSC

  49 RUR order

• Ceftriaxone (vial 1g i.v. i.m. individual pack)DECO Company

  1205 rub. order

• Ceftriaxone (vial 1g intravenous i.m. individual pack) Kraspharma OJSC

  42 RUR order

• Ceftriaxone (vial 1g i.v. i.m. ind. pack) BZMP

  52 RUR order

• Ceftriaxone (vial 1g i.v. i.m. individual pack) Sintez (Kurgan) OJSC

  31 rub. order

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Pharmacy24

• Ceftriaxone 1 g N10 powder PAT "Kievmedpreparat", Ukraine
  151 UAH.order
• Ceftriaxone-BHFZ 500 mg No. 1 powder PAT NVC "Borshchagivsky chemical-pharmaceutical plant", Kiev, Ukraine

  11 UAH order

• Ceftriaxone-Darnitsa 0.5 g N5 lyophilisate for the preparation of solution for injection PrAT" Pharmaceutical company "Darnitsa", Ukraine

  58 UAH order

• Ceftriaxone-Darnitsa 1 g No. 5 solution PrAT” Pharmaceutical company “Darnitsa”, Ukraine

  72 UAH order

• Ceftriaxone 1.0 g No. 1 powder AT Lekhim-Kharkiv, Ukraine

  13 UAH order

PaniPharmacy

• Ceftriaxone bottle Ceftriaxone sodium salt powder for injection 1g Ukraine, Kievmedpreparat OJSC

  169 UAH order

• CEFTRIAXONE bottle Ceftriaxone powder for injection 1g No. 5 Ukraine, Lekhim-Kharkov JSC

  74 UAH order

• Ceftriaxone bottle Ceftriaxone sodium salt powder for injection 0.5g Ukraine, Kievmedpreparat OJSC

  110 UAH order

• Ceftriaxone bottle Ceftriaxone powder for injection 1g bottles No. 40 Ukraine, Darnitsa ChAO

  681 UAH order

• CEFTRIAXONE bottle Ceftriaxone powder for injection 1g Ukraine, Lekhim-Kharkov JSC

  15 UAH order

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general provisions

The injectable drug ceftriaxone is widely used in veterinary medicine.

in several forms:

• each 0.5 g bottle contains dry matter equivalent to 0.5 g of the drug (sterile)
• each 1 g vial contains dry substance equivalent to 1 g ceftriaxone (sterile)
• Each 2 g bottle contains dry matter equivalent to 2 g of the drug (sterile)

According to the instructions, ceftriaxone injections are used to treat the following infections in animals

caused by susceptible microorganisms:

• respiratory tract infections
• acute bacterial otitis
• skin infections
• urinary tract infections
• respiratory tract infections
• bone and joint infections
• bacterial septicemia
• intra-abdominal infection