Antibiotics ceftriaxone

A new property of the known third-generation antibiotic ceftriaxone has been documented as a potential neu-rotherapeutic, modulating the expression of glutamate neurotransmitter transporters, GLT1, via gene activation... 

For most patients, oral antibiotics (doxycycline or amoxicillin) are prescribed for 21 days. When symptoms indicate nervous system involvement or a severe episode of Lyme disease, intravenous antibiotic (ceftriaxone) may be given for 14-30 days. Some physicians consider intravenous ceftriaxone the best therapy for any late manifestation of disease, but this is controversial. Corti-... 

Disseminated gonococcal infections often respond quickly to antibiotics. Ceftriaxone 1 g/day for 7 to 10 days is the treatment of choice. After culture and sensitivity results are available and the organism is determined to be sensitive, therapy can be switched on the fourth day to oral amoxicillin or to doxycycline or tetracycline to complete the 7- to 10-day course. Clinical resolution of signs and symptoms usually is rapid. 

Thone-Reineke C, Neumann C, Namsolleck P et al (2008) The beta-lactam antibiotic, ceftriaxone, dramatically improves survival, increases glutamate uptake and induces neuro-trophins in stroke. J Hypertens 26 2426-2435... 

The 72-year-old client is admitted to the medical unit diagnosed with an acute exacerbation of diverticulosis. The health-care provider has prescribed the intravenous antibiotic ceftriaxone (Rocephin). Which intervention should the nurse implement first ... 

The nurse is caring for the client in septic shock. The nurse administered the twice-a-day, intravenous, broad-spectrum antibiotic ceftriaxone (Rocephin) at 0900. At 1100 the health-care provider prescribed daily intravenous vancomycin, an aminoglycoside antibiotic. Which action should the nurse implement ... 

In addition, 6-hydroxy-2-methyl-3-thioxo-2//-l,2,4-triazin-5-one, the subunit fragment of antibiotic ceftriaxone, was characterized by NMR spectroscopy <1996SC2075>. 

Nitrobenzene originates from numerous industrial and agricultural activities, and can be abiotically removed at a cathode coupled to microbial oxidation of acetate at an anode, as shown by Mu et al. [140]. Finally, a model antibiotic (ceftriaxone) was shown to be oxidatively removed and to boost current production from glucose in the anode in an air-cathode MFC [137]. 

Complicated exacerbation FEV, less than 50% predicted Comorbid cardiac disease Greater than or equal to 3 exacerbations per year Antibiotic therapy in the previous 3 months Above organisms plus drug-resistant pneumococci, P-lactamase-producing H. influenzae and M. catarrhalis, Escherichia coli, Proteus spp., Enterobacter spp., Klebsiella pneumoniae Oral P-Lactam/P-Iactamase inhibitor (amoxicil 1 i n-clavulanate) Fluoroquinolone with enhanced pneumococcal activity (levofloxacin, gemifloxacin, moxifloxacin) Intravenous P-Iactam/P-Iactamase inhibitor (ampicillin-sulbactam) Second- or third-generation cephalosporin (cefuroxime, ceftriaxone) Fluoroquinolone with enhanced pneumococcal activity (levofloxacin, moxifloxacin)... 

Treat hyperacute bacterial conjunctivitis with a single dose of 1 g of intramuscular ceftriaxone in combination with topical antibiotics.11... 

Broad-spectrum antibiotic cefotaxime or ceftriaxone (clindamycin for cephalosporin allergy) vancomycin for staphylococcal and resistant pneumococcal organisms... 

Broad intravenous antibiotic coverage for the encapsulated organisms can include ceftriaxone or cefotaxime. For patients with true cephalosporin allergy, clindamycin may be used. If staphylococcal infection is suspected owing to previous history or the patient appears acutely ill, vancomycin should be initiated. Macrolide antibiotics, such as erythromycin and azithromycin, may be initiated if Mycoplasma pneumonia is suspected. While the patient is receiving broad-spectrum antibiotics, their regular use of penicillin for prophylaxis can be suspended. Fever should be controlled with acetaminophen or ibuprofen. Because of the risk of dehydration during infection with fever, increased fluid may be needed.6,27... 

Development of resistance to P -lactam antibiotics, including penicillins and cephalosporins, has significantly impacted the management of bacterial meningitis. Approximately 17% of United States pneumococcal CSF isolates are resistant to penicillin, and 3.5% of CSF isolates are resistant to cephalosporins.26 The Clinical and Laboratory Standards Institute (CLSI) has set a lower ceftriaxone susceptibility breakpoint for pneumococcal CSF isolates (1 mg/L) than for isolates from non-CNS sites (2 mg/L). Increasing pneumococcal resistance to penicillin G... 

Duration of therapy, like drug selection, depends on patient age and disease severity. Standard 10-day oral therapy is more effective than shorter courses for uncomplicated AOM in children younger than 2 years of age and those with recurrent infections, as well as in older patients with severe illness.5,24 Exceptions to the 10-day regimen are for azithromycin and ceftriaxone. In older children with mild or moderate illness, antibiotic therapy is needed only for 5 to 7 days. 

Patients with complicated typhoid fever (i.e., metastatic foci, ileal perforation, etc.) should receive parenteral therapy with ciprofloxacin 400 mg twice daily or ceftriaxone 2000 mg once daily. Antimicrobial therapy can be completed with an oral agent after initial control of the symptoms of typhoid fever. In persons with AIDS and a first episode of Salmonella bacteremia, a longer duration of antibiotic therapy (1-2 weeks of parenteral therapy followed by 4 weeks of oral fluoroquinolone) is recommended to prevent relapse of bacteremia. 

Fever of 38.5°C (101.3°F) or higher should be evaluated promptly. A low threshold for empiric antibiotic therapy with coverage against encapsulated organisms is recommended (e.g., ceftriaxone for outpatients and cefotaxime for inpatients). 

For bacteremia, life-threatening treatment should include the combination of a third-generation cephalosporin (ceftriaxone 2 g IV daily) and ciprofloxacin 500 mg orally twice daily. The duration of antibiotic therapy is dictated by the site. 

As streptococcal cellulitis is indistinguishable clinically from staphylococcal cellulitis, administration of a semisynthetic penicillin (nafrillin or oxacillin) or first-generation cephalosporin (cefazolin) is recommended until a definitive diagnosis, by skin or blood cultures, can be made (Table 47-4). If documented to be a mild cellulitis secondary to streptococci, oral penicillin VK, or intramuscular procaine penicillin may be administered. More severe streptococcal infections should be treated with IV antibiotics (such as ceftriaxone 50 to 100 mg/kg as a single dose). 

Which route of administration is optimum Choosing the optimum dmg administration route takes into account the specific circumstances of each individual case. For example, can the patient tolerate oral medications, or is intravenous administration required Does the patient have venous access For how long can it be maintained Is intramuscular administration a possibility In many clinical situations, the available formulation determines the route of administration. Antibiotics are a prime example of this phenomenon ceftriaxone, for example, is available only for parenteral administration while amoxicillin is administered orally. 

The cephalosporins distribute in satisfactory concentrations to most tissues except the central nervous system. Only cefepime, cefuroxime (Zinacef), cefotaxime (Claforan), ceftriaxone Rocephin), and ceftazidime (Eortaz) achieve therapeutic concentrations in cerebrospinal fluid. Cefotaxime and ceftriaxone are antibiotics of first choice for the empirical treatment of brain abscess and meningitis. 

Chloramphenicol remains a major treatment of typhoid and paratyphoid fever in developing countries. However, with increasing resistance to ampicillin, trimethoprim-sulfamethoxazole and, to some extent, chloramphenicol, fluoroquinolones and some third-generation cephalosporins (e.g., ceftriaxone) have become the drugs of choice. Salmonella infections, such as osteomyelitis, meningitis and septicemia, have also been indications for chloramphenicol use. Nevertheless, antibiotic resistance patterns can be a problem. As noted previously, nonty-phoidal salmonella enteritis is not benefited by treatment with chloramphenicol or other antibiotics. 

---