Ceftriaxone

Adults and children over 12 years (>=50 kg). Dose depends on severity, susceptibility, site and type of infection and on hepato-renal function. Per SPC table: 1-2 g once daily for community acquired pneumonia, acute exacerbations of COPD, intra-abdominal infections and complicated urinary tract infections (including pyelonephritis); 2 g once daily for hospital acquired pneumonia, complicated skin and soft tissue infections and infections of bones and joints; 2-4 g once daily for management of neutropenic patients with fever suspected bacterial, bacterial endocarditis and bacterial meningitis. In documented bacteraemia the higher end of the range should be considered. Twice daily (12 hourly) administration may be considered where doses greater than 2 g daily are administered. Specific schedules: acute otitis media 1-2 g as a single IM dose (may be 1-2 g daily IM for 3 days if severely ill or previous therapy failed); pre-operative prophylaxis of surgical site infections 2 g as a single pre-operative dose; gonorrhoea 500 mg as a single IM dose; syphilis 500 mg-1 g once daily increased to 2 g once daily for neurosyphilis for 10-14 days (limited data; follow national/local guidance); disseminated Lyme borreliosis 2 g once daily for 14-21 days. Duration: continue for 48-72 hours after the patient has become afebrile or bacterial eradication achieved. Paediatric (SPC): children with bodyweight 50 kg or more should receive the usual adult dosage; for children 15 days to 12 years (<50 kg) and neonates 0-14 days the SPC gives weight-based dosing (see paediatric formulary) — ceftriaxone is contraindicated in premature neonates up to a postmenstrual age of 41 weeks; verify all paediatric dosing against a children's formulary.