Ceftriaxone for injection should not be used in neonates (especially prematures) at risk of developing bilirubin encephalopathy.
Changes in bowel flora may be more marked than with cefotaxime because of the greater biliary excretion of ceftriaxone; diarrhoea may occur more often, especially in children. Biliary sludge or pseudolithiasis due to a precipitate of calcium ceftriaxone has been seen occasionally in patients given ceftriaxone.
Neutropenia has been reported with most cephalosporins; a complex mechanism has been attributed to that associated with ceftriaxone. There have been rare reports of fatal haemolysis associated with ceftriaxone.
Although ceftriaxone has a N-methylthiotriazine ring rather than a N-methylthiotetrazole side-chain, it might still have the potential to cause hypoprothrombinaemia.
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