Ceftriaxone

Adults and children over 12 years (>=50 kg). Dose depends on severity, susceptibility, site and type of infection. SPC table: 1-2 g once daily for community acquired pneumonia, acute exacerbations of COPD, intra-abdominal infections, complicated UTI/pyelonephritis; 2 g once daily for hospital acquired pneumonia, complicated skin and soft tissue infections, bone and joint infections; 2-4 g once daily for neutropenic patients with fever suspected to be bacterial, bacterial endocarditis and bacterial meningitis. In documented bacteraemia use the higher end of the range. Twice daily (12 hourly) may be considered where doses greater than 2 g daily are given. Specific ID indications: 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 (early Stage II and late Stage III) 2 g once daily for 14-21 days; acute otitis media 1-2 g single IM dose (or 1-2 g daily IM for 3 days if severely ill or previous therapy failed); pre-operative surgical prophylaxis 2 g single dose. Duration of therapy varies; continue for 48-72 hours after the patient is afebrile or bacterial eradication achieved. Paediatric weight-based schedules (children 15 days-12 years <50 kg and neonates 0-14 days) are given in the SPC — contraindicated in premature neonates up to postmenstrual age 41 weeks; verify all paediatric dosing against a children's formulary.