Ceftriaxone (Injection Route)

As a cephalosporin antibiotic, Ceftriaxone is injected before surgery to prevent infections or to treat bacterial infections in progress throughout the body.

Overview:

Ceftriaxone is an injectable antibiotic marketed under the brand name Rocephin. Its primary use is to help the body resist bacterial infections, many of which can be life-threatening. It falls under a class of antibiotics known as cephalosporin antibiotics and is commonly injected before certain surgeries to prevent infection, although it is also administered when there is a known infection in order to help the body fight off the infection. The medication works by inhibiting the growth of bacteria in the area of the body that it is injected into and is very effective when used for this purpose.

Conditions treated:

  • Bacterial Infections
  • Menengitis

Type of medicine:

  • Antibiotic

Side Effects:

While intended only as an antibiotic, Ceftriaxone can also have other unexpected effects on the body. Some may be serious enough to merit medical attention when they do occur. Some of the more common of these serious side effects can manifest as flu-like symptoms including chills, a cough, fever, sore throat, swollen glands, and shortness of breath. Some patients receiving the injection have also reported diarrhea or black, tarry stools. Some of the reported side effects can be quite painful, including chest pains, painful urination, and sores and ulcers of the mouth area. Other commonly reported side effects include unusual fatigue and bleeding or bruising more easily.

Some side effects are just as serious but more rarely seen. These effects are numerous and are listed below:

  • Abdominal or stomach cramps or tenderness
  • Back, leg, or stomach pains
  • Bleeding gums
  • Bloating
  • Bloody urine or stools
  • Bloody nose
  • Bluish color
  • Changes in skin color
  • Clay-colored stools
  • Convulsions
  • Dark urine
  • Bloody Diarrhea
  • Difficulty breathing
  • Difficulty swallowing
  • Dizziness
  • Fast, irregular, pounding, or racing heartbeat
  • Feeling of discomfort
  • Feeling of unusual warmth
  • General body swelling
  • General feeling of tiredness or weakness
  • Headache
  • Hives
  • Increased sweating
  • Increased thirst
  • Inflammation of the joints
  • Itching
  • Loss of appetite
  • Lower back or side pain
  • Muscle aches
  • Nausea or vomiting
  • Noisy breathing
  • Nosebleeds
  • Pale skin
  • Pinpoint red spots on the skin
  • Puffiness or swelling of the facial or mouth area
  • Rash
  • Redness of the face, neck, arms, and occasionally, upper chest
  • Shortness of breath
  • Skin rash
  • Swelling of the foot or leg
  • Swollen lymph glands
  • Tenderness
  • Tightness in the chest
  • Troubled breathing with exertion
  • Unpleasant breath odor
  • Unusual weight loss
  • Vomiting of blood
  • Watery or bloody diarrhea
  • Wheezing
  • Yellowing of the eyes or skin

Other serious side effects have been reported, but their incidence is unknown. some patients have had blisters often accompanied by loosening or peeling of the skin. These can also occur as lesions with a purple center. Others have coughed up blood or had other bleeding problems such as an increased menstrual flow or prolonged bleeding from cuts or incisions. Some experience restlessness or an inability to stand still. Muscle problems have been observed including excessive tone, stiffness, tension, and tightness. Odd side effects that have come up include a decrease in urine flow, red irritated eyes, and even paralysis.

While the previous side effects are quite serious, other side effects are considered more routine and temporary in nature. Once the body adjusts to the medication the effects usually subside. Most will require no medical attention but if they last too long a doctor should be informed. Some of these side effects include distress of the digestive system including gas, bloating, a sour stomach, feeling of fullness in the stomach, indigestion, heartburn, flatulence, and a change or loss of taste. Patients also may briefly experience itching of the genital area or pain during intercourse, sometimes accompanied by a thick white discharge. A headache or dizziness are also reported.

Other miscellaneous temporary symptoms whose incidence is not well known have included the following: swelling or inflammation of the mouth, hives/welts, and redness, swelling, or soreness of the tongue.

Dosage:

While Ceftriaxone injections are handled by qualified medical personnel, there are certain things every recipient should know. This injection should be received only as prescribed by the prescribing physician. This medication is not to be used in larger or smaller amounts than recommended or for a longer or shorter duration. The medication will be injected into a vein or through an IV, and if instructed in its use you may administer the injection. Proceed with caution and do not perform the injection if you do not know the exact amount or do not know how to dispose of the used needles. The medication may need to be mixed with a liquid diluent before use. Use only liquid diluent that has been provided by your doctor specifically for that purpose. It is important that Ceftriaxone is used for the full length of time and not be discontinued at the point where you feel better, as the infection may persist after symptoms have disappeared.

Interactions:

Certain medications will have a detrimental reaction to Ceftriaxone and should not be used together if it will impact the effectiveness of one or more of the medications' ability to treat the conditions they are prescribed for. Some of the medicines known to cause more notable reactions have been listed below. It is not recommended that these be used with Ceftriaxone unless deemed absolutely necessary by your doctor.

  • Calcium Acetate
  • Calcium Chloride
  • Calcium Gluceptate
  • Calcium Gluconate
  • Lactated Ringer's Solution
  • Ringer's Solution

Other medications may be prescribed together in spite of known side effects if your doctor is aware of them and their potential effects. In some cases, these side effects can be mitigated by adjusting prescriptions. This is the case with the live cholera vaccine if it is necessary during treatment for an infection. Warfarin is also known to have an increased risk of certain side effects when prescribed with Ceftriaxone.

If you have any of the following medical problems or have a history of them, inform your doctor prior to taking Ceftriaxone as these conditions may interact poorly with the medication or it could make the conditions worse. Patients should also beware of using Ceftriaxone in an undernourished condition.

  • Anemia
  • Diarrhea
  • Gallbladder disease
  • Pancreatitis
  • Stomach or bowel disease
  • Hyperbilirubinemia
  • Kidney disease
  • Liver disease

Warnings:

Ceftriaxone is meant to be a fast-acting treatment, and if there are no signs of improvement in condition within a few days the doctor who prescribed it should be immediately informed as this can indicate an antibiotic-resistant strain. Injections of Ceftriaxone have on occasion been known to cause a serious allergic reaction known as anaphylaxis. This can be a life-threatening condition if it is left untreated, and medical attention should be sought immediately if any of the following symptoms occur:

  • Difficulty breathing
  • Difficulty swallowing
  • Shortness of breath
  • Itching
  • Hives
  • Swelling of face, hands, or mouth

While Ceftriaxone has been known to cause severe diarrhea, it is not recommended to treat the condition with any over-the-counter remedy without checking with your doctor first. The wrong treatment may lead to the condition lasting longer or growing more severe. Do not take any medication, supplements, or vitamins that your doctor is not aware of during the course of this antibiotic series.

You should inform your doctor right away if you receive sudden and severe stomach pain at any time while using Ceftriaxone as this can indicate that you are suffering from pancreatitis, which Ceftriaxone has been known to contribute to. Other indications that should be reported to a medical care provider include lightheadedness, fever, chills, nausea, stomach pain, constipation, and vomiting.

Storage:

While this medication will usually be stored by medical professionals in a hospital environment, if asked to maintain a supply in your home follow these guidelines. Store the unmixed powder at room temperature away from sources of heat, light, and moisture. If in a frozen liquid form it should be maintained in a freezer until it is time for it to be used, at which time it is to be slowly thawed at room temperature rather than warmed by any other method. Use the medication immediately upon thawing. Do not refreeze the dose. Keep this and all medication in a secure location away from the reach of children or family pets and dispose of it properly when no longer needed.

Summary:

In general, Ceftriaxone is an effective and possibly life-saving antibiotic treatment for serious bacterial infections. However, there is reason for caution regarding overusing it or not using a sufficient dose to kill the bacteria that is causing the infection. This can lead to antibiotic-resistant bacteria and more serious occurrences of the infection. It is recommended that prior to using Ceftriaxone to combat an infection that the specimens of the microorganism that is causing the infection be taken and analyzed to determine if it will be susceptible to treatment by the antibiotic. There are also some risks in using Ceftriaxone including serious side effects as well as a potentially severe allergic reaction that can occur in some patients. It is also not to be used in the treatment of viral infections such as the flu or common cold.

Resources