Ceftriaxone
General Information
Do NOT use if patient has a history of severe penicillin allergy. If in doubt, discuss with Microbiology/ID.
Formulary antimicrobial: Use in accordance with Trust guidelines. All other indications must be recommended/prescribed by a Micro/ID consultant or registrar.
AWaRe antibiotic classification: 'Watch'. Use as per guidelines. All other indications to be discussed with Micro/ID.
Obesity
Dose at the top end of the dose recommendations in obese patients, taking into account renal and hepatic function.
Renal and hepatic impairment
Renal impairment
|
eGFR (mL/min/1.73m2) |
Dose |
|
More than 10 |
Dose as in normal renal function |
|
Less than 10 |
Max 2g per day |
|
HDF/High flux |
Dose as in eGFR less than 10ml/min/1.73m2. Unknown dialysability |
|
HD/PD |
Dose as in eGFR less than 10ml/min/1.73m2 . Not dialysed |
Hepatic impairment
- There is no need to reduce the dose in mild or moderate hepatic impairment, providing renal function is intact.
- If both hepatic and severe renal impairment, close clinical monitoring for safety and efficacy is advised. Ask a pharmacist for further advice.
Pregnancy and breastfeeding
Pregnancy
Safe to use in pregnancy
Breastfeeding
Drug present in milk in low concentrations but safe to use
References
- Summary of Product Characteristics (SPC) for Ceftriaxone 1g Powder for solution for Injection. Accessed via www.medicines.org.uk 26/03/18. Last updated 04/08/17
- The Renal Drug Database. Ceftriaxone. Accessed via renaldrugdatabase.com 26/03/18. Last updated 09/11/17
- Drugs in Pregnancy and Lactation. Briggs G et al. 6th Edition.
- UKMI (2017) How should antibiotics be dosed in obesity? accessed via https://www.sapg.scot/media/4329/howshouldantibioticsbedosedinobesity_2016_update.pdf
- UKCPA Critical Care Group (2013) Drug dosing in extremes of body weight in critically ill patients.