Ceftriaxone dosing

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

Host factors can help to ensure selection of the most appropriate antimicrobial agent. Age is an important factor in antimicrobial selection. With regard to dose and interval, renal and hepatic function varies with age. Populations with diminished renal function include neonates and the elderly. Hepatic function in the neonate is not fully developed, and drugs that are metabolized or eliminated by this route may produce adverse effects. For example, sulfonamides and ceftriaxone may compete with bilirubin for binding sites and may result in hyperbilirubinemia and kernicterus. Gastric acidity also depends on... 

Ceftriaxone 125 mg intramuscularly as a single dose plus therapy recommended for co-infection with Chlamydia... 

Ceftriaxone 25 to 50 mg/kg intravenously or intramuscularly as a single dose for ophthalmia neonatorum or infants born to mothers with gonococcal infection as prophylaxis... 

Alternatives Oral doxycycline 100 mg twice daily for 2 weeks or tetracycline 500 mg by mouth four times daily for 2 weeks. Limited literature also supports the use of ceftriaxone 1 g intramuscularly or intravenously once daily for 10 days or oral azithromycin as a single 2-g dose.13... 

Alternative treatments for non-pregnant penicillin-allergic patients doxycycline 100 mg orally twice daily for 2 weeks, or tetracycline 500 mg four times daily for 2 weeks limited data support ceftriaxone 1 g once daily IM or IV for 8 to 10 days or azithromycin, 2 g orally (single dose). 

Levofloxacin 500 mg PO daily for 14 days with or without metronidazole 500 mg PO twice daily for 14 days Ceftriaxone 250 mg IM single dose and probenecid 1 g single dose, plus doxycycline 100 mg PO twice daily for 14 days with or without metronidazole, 500 mg PO twice daily for 14 days Third-generation cephalosporin plus doxycycline 100 mg PO twice daily for 14 days with or without metronidazole 500 mg PO twice daily for 14 days... 

The treatment of choice is ceftriaxone, 125 mg intramuscularly (IM) as a single dose or cefixime, 400 mg orally in a single dose. Spectinomycin 2 g IM as a single dose is appropriate as a second choice. 

Recommended therapy in the uncomplicated case caused by fully susceptible strains is 4 weeks of either high-dose penicillin G or ceftriaxone, or 2 weeks of combined therapy with high-dose penicillin G plus gentamicin (Table 37-3). 

Aqueous crystalline pen- Pediatric dcv penicillin 200,000 urnls/kg per 24 hours IV in four to six equally divided doses ceftriaxone 100 mg/kg per 24 hours IV/IM in one dose 12-18 million units/24 h IV either continuously or in six equally divided 2 IB 2-week regimen not intended for patients with known cardiac or extracar-... 

For patients with complicated infection (e.g., extracardiac foci) or when the organism is relatively resistant (MIC = 0.12 to 0.5 mcg/mL), combination therapy with an aminoglycoside and penicillin (higher dose) or ceftriaxone for the first 2 weeks is recommended (Table 37-4). 

Ceftriaxone sodium plus Gentamicin sulfate 2 g/24 hours IV/IM in one dose 4 IB cal endocarditis (see Table 37-8)... 

Vancomycin hydrochloride 30 mg/kg per 24 hours IV in two equally divided doses not to exceed 2 g/24 hours unless serum concentrations are inappropriately low Pediatic dose 40 mg/kg 24 hours in two or three equally divided doses 4 IB Vancomycin therapy recommended only for patients unable to tolerate penicillin or ceftriaxone therapy... 

If treatment failure occurs with amoxicillin, an agent should be chosen with activity against /1-lactamase-producing H. influenzae and M. catar-rhalis as well as drug-resistant S. pneumoniae (such as high-dose amoxicil-lin-clavulanate (recommended), or, cefuroxime, cefdinir, cefpodoxime, cefprozil, or intramuscular ceftriaxone). 

All currently recommended regimens are single-dose treatments with various oral or parenteral cephalosporins and fluoroquinolones (Table 46-4). Ceftriaxone is the only parenteral agent recommended by the CDC as a first-line agent for treatment of gonorrhea. 

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). 

Cerebrospinal fluid shunt procedures 5. aureus, S. epidermidis Cefazolin 1 g every 8 hours x 3 doses or ceftriaxone 2 gx 1 No agents have been shown to be better than cefazolin in randomized comparative trials. IA... 

Epididymitis most likely caused by gonococcal or chlamydial infection 100 mg twice daily for 10 days plus a single dose of 250 mg ceftriaxone IM. 

Cefotaxime can be used in infections due to beta-lactamase producing strains of H. influenzae and N. gonorrhoeae. Ceftriaxone has an antibacterial spectrum similar to that of cefotaxime but its longer half-life allows for less frequent dosing. Ceftazidime is especially effective against Pseudomonas aeruginosa. Cetixime and cefpodoxime are third-generation cephalosporins that can be administered orally. 

Ulcus molle/chancroid is treated with a single dose of either ceftriaxone i.m. or with azithromycin 1 g orally. Three days of oral ciprofloxacin 2 x 500 mg daily or 7 days of amoxicillin/clavulanic acid 3 X 500/125 mg orally or erythromycin 4 x 500 mg orally are alternatives. 

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