Tricefin

0 to 2 Weeks Old

20-50 mg/kg body weight once daily, not exceed 50 mg/kg body weight. The daily dosage should not exceed 50 mg/kg body weight on account of the immaturity of the infant’s enzyme systems.

3 Weeks to 12 Years Old

The daily dose is 20-80 mg/kg of body weight. For children with body weight ≥ 50 kg usual dosage is the same as adult dosage. Intravenous doses of 50 mg/kg body weight or more should be given by infusion for at least 30 minutes.

12 to 65 Years Old

Usual dose: 1-2 g once daily (every 24 hours). In severe infections and in cases in which the pathogens are only moderately sensitive, the daily dosage may be increased to 4 g once daily.

Geriatric Patients

The recommended dosages as the dosage for adults. No adjustment dosage is required in geriatric patients.

Duration of Therapy

The duration of therapy varies according to the course of the disease. As with antibiotic therapy in general, administration of ceftriaxone should be continued for a minimum of 48 to 72 hours after the patient has become afebrile or evidence of bacterial eradication has been obtained.

Combination Therapy

Synergy between ceftriaxone and aminoglycosides has been demonstrated with many Gram-negative bacteria. Although enhanced activity of such combinations is not always predictable, it should be considered in severe, life-threatening infections due to microorganisms such as Pseudomonas aeruginosa. As the two antibiotic agents are incompatible, they must be administered separately at the recommended dosages.

Special Dosage Instructions

Meningitis:
The treatment of meningitis in infants and children, treatment begins with doses of 100 mg/kg (up to a maximum of 4 g) once daily. As soon as the causative organism has been identified and its sensitivity determined, the dosage can be reduced accordingly.

Treatment courses that have been found effective include:

• Neisseria meningitidis: 4 days
• Haemophylus influenzae: 6 days
• Streptococcus pneumoniae: 7 days

Gonorrhea:
For the treatment of gonorrhea by penicillinase-producing and non-penicillinase-producing strains), a single intramuscular dose of 250 mg ceftriaxone is recommended.

Perioperative prophylaxis:
To prevent postoperative infections in contaminated or potentially contaminated surgery, the recommended approach – depending on the risk of infection – is a single dose of 1 to 2 g ceftriaxone administered 30 to 90 minutes prior to surgery.

In colorectal surgery, concurrent treatment of ceftriaxone with or without a 5-nitroimidazole, e.g., ornidazole (administered separately) has proven effective.

Impaired Renal and Hepatic Function

In patients with impaired renal function, there is no need to reduce the dosage of ceftriaxone provided hepatic function is intact. Only in cases of pre-terminal renal failure (creatinine clearance <10 ml/minute) the ceftriaxone dosage should not exceed 2 g daily. In patients with liver damage, there is no need for the dosage to be reduced provided renal function is intact. In cases of concomitant severe renal and hepatic dysfunction, determine the plasma concentrations of ceftriaxone at regular intervals. Patients undergoing dialysis require no additional supplementary dosing following the dialysis. Plasma concentrations should, however, be monitored, to determine if dosage adjustments are necessary, since in these patients, the elimination rate may be altered.