Pneumosolv

Infections in adults & childn including term neonates (from birth): Bacterial meningitis, community acquired pneumonia, hospital acquired pneumonia, acute otitis media, intra-abdominal infections, complicated UTI (including pyelonephritis), bone & joint infections, complicated skin & soft tissue infections, gonorrhoea, syphilis, bacterial endocarditis. Treatment of acute exacerbations of COPD in adults; disseminated Lyme borreliosis [early (stage II) & late (stage III)] in adults & childn including neonates from 15 days of age; patients w/ bacteraemia that occurs in association w/, or is suspected to be associated w/, any of the infections mentioned. Management of neutropenic patients w/ fever that is suspected to be due to bacterial infection. Pre-op prophylaxis of surgical site infections.

IM/IV Adult & childn >12 yr (≥50 kg) Community acquired pneumonia, acute exacerbation of COPD, intra-abdominal infection, complicated UTI (including pyelonephritis) 1-2 g once daily. Consider higher end of recommended dose range in documented bacteraemia. Hospital acquired pneumonia, complicated skin & soft tissue infection, bone & joint infection 2 g once daily. Management of neutropenic patient w/ fever that is suspected to be due to bacterial infection, bacterial endocarditis/meningitis 2-4 g once daily. Consider higher end of recommended dose range in documented bacteraemia. Consider bid (12 hrly) administration where doses >2 g daily are administered. Acute otitis media 1-2 g single IM dose. Pre-op prophylaxis of surgical site infection 2 g as single pre-op dose. Gonorrhoea 500 mg single IM dose. Syphilis 500 mg-1 g once daily increased to 2 g once daily for neurosyphilis for 10-14 days. Disseminated Lyme borreliosis [early (stage II) & late (stage III)] 2 g once daily for 14-21 days. Neonate, infant & childn 15 days to 12 yr (<50 kg) Intra-abdominal infection, complicated UTI (including pyelonephritis), community acquired pneumonia, hospital acquired pneumonia 50-80 mg/kg once daily. Consider higher end of recommended dose range in documented bacteraemia. Complicated skin & soft tissue infection, bone & joint infection, management of neutropenic patient w/ fever that is suspected to be due to bacterial infection 50-100 mg/kg once daily. Max: 4 g. Consider higher end of recommended dose range in documented bacteraemia. Consider bid (12 hrly) administration where doses >2 g daily are administered. Bacterial meningitis 80-100 mg/kg once daily. Max: 4 g. Consider higher end of recommended dose range in documented bacteraemia. Consider bid (12 hrly) administration where doses >2 g daily are administered. Bacterial endocarditis 100 mg/kg once daily. Max: 4 g. Consider bid (12 hrly) administration where doses >2 g daily are administered. Acute otitis media Initially 50 mg/kg single IM dose. Pre-op prophylaxis of surgical site infection 50-80 mg/kg as single pre-op dose. Syphilis 75-100 mg/kg (max 4 g) once daily for 10-14 days. Disseminated Lyme borreliosis [early (stage II) & late (stage III)] 50-80 mg/kg once daily for 14-21 days. Neonate 0-14 days Max: 50 mg/kg daily dose should not be exceeded. Intra-abdominal infection, complicated skin & soft tissue infection, complicated UTI (including pyelonephritis), community acquired pneumonia, hospital acquired pneumonia, bone & joint infection, management of neutropenic patient w/ fever that is suspected to be due to bacterial infection 20-50 mg/kg once daily. Consider higher end of recommended dose range in documented bacteraemia. Bacterial meningitis/endocarditis 50 mg/kg once daily. Patient w/ preterminal renal failure (CrCl <10 mL/min) Dose should not exceed 2 g daily.

Hypersensitivity to ceftriaxone or to any other cephalosporin. History of severe hypersensitivity (eg, anaphylactic reaction) to any other type of β-lactam antibacterial agent (penicillins, monobactams & carbapenems). Premature neonates up to postmenstrual age of 41 wk (gestational age + chronological age). Full-term neonates (up to 28 days of age) w/ hyperbilirubinaemia, jaundice, or who are hypoalbuminaemic or acidotic; if they require (or are expected to require) IV Ca treatment, or Ca-containing infusions. Exclude lidocaine contraindications before IM inj of ceftriaxone when lidocaine soln is used as solvent. Ceftriaxone soln containing lidocaine should never be administered IV.

Reports of serious & occasionally fatal hypersensitivity reactions; severe cases of haemolytic anaemia; antibacterial agent-associated colitis & pseudo-membranous colitis; cases of pancreatitis, possibly of biliary obstruction aetiology; renal lithiasis. Discontinue treatment & initiate adequate emergency measures in case of severe hypersensitivity reactions. Caution to patients w/ history of non-severe hypersensitivity to other β-lactam agents. Must not be mixed or administered simultaneously w/ any Ca-containing IV soln. Perform CBC at regular intervals during prolonged treatment. Some patients w/ spirochete infections may experience Jarisch-Herxheimer reaction. Contains Na (85.4 mg/vial). Interference w/ Coombs tests; false +ve test results for galactosaemia & non-enzymatic methods for glucose determination in urine. Consider possibility of precipitates of Ca ceftriaxone when shadows are observed on sonograms. Close clinical monitoring for patients w/ severe renal & hepatic insufficiency. Should only be administered during pregnancy, particularly in 1st trimester, if benefit outweighs the risk. Discontinue breast-feeding during treatment or abstain from ceftriaxone therapy, taking into account the benefit of breast feeding for the child & the benefit of therapy for the woman. Reports of encephalopathy, particularly in elderly patients w/ severe renal impairment or CNS disorders; consider discontinuation of therapy if encephalopathy is suspected.

Eosinophilia, leucopenia, thrombocytopenia; diarrhoea, loose stools; increased hepatic enzyme; rash.

Precipitate can form w/ Ringer's/Hartmann's soln (Ca-containing diluents); can also occur when ceftriaxone is mixed w/ Ca-containing soln in the same IV administration line. May increase anti-vit K effect & risk of bleeding w/ oral anticoagulants. Monitor aminoglycoside levels (& renal function) when used w/ aminoglycosides.

Cephalosporins

J01DD04 - ceftriaxone ; Belongs to the class of third-generation cephalosporins. Used in the systemic treatment of infections.

Rx