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Adults and children over 12 years old of age: 1-2 g (potency) of ceftriaxone sodium administered once daily intravenously or intramuscularly. In severe cases or in infections caused by moderately sensitive organisms, the dosage may be increased to 4 g (potency) once daily.
Neonates (within 14 days): A daily dose of 20-50 mg/kg (potency) of body weight, not to exceed 50 mg/kg (potency). It is not necessary to differentiate between premature and infants born at full term.
Infants and children (15 days to twelve years): 20-80 mg/kg (potency) is administered once daily. For children with bodyweight of 50 kg or more, the usual adult dosage should be used. An intravenous doses of 50 mg (potency) or more per kg bodyweight should be given by infusion over at least 30 minutes.
Geriatric patients: the dosage recommended for adults is applied to geriatric patients.
Meningitis: In bacterial meningitis in infants and children, treatment begins with doses of 100 mg (potency) per kg (not to exceed 4 g (potency) once daily. As soon as the causative organism has been identified and its sensitivity determined, the dosage can be reduced accordingly. The following duration of therapy has shown to be effective (N. meningitidis: 4 days, H. influenzae: 6 days, S. pneumoniae: 7 days).
Gonorrhea: For the treatment of gonorrhea (penicillinase producing and nonpenicillinase-producing strains), a single I.M. dose of 250 mg (potency) is recommended.
Perioperative prophylaxis: To prevent postoperative infection in contaminated or potentially contaminated surgery, the recommended approach-depending on the risk of infection is a single dose of 1-2 g (potency) administered 30-90 minutes prior to surgery. In colorectal surgery, concurrent (but separate) administration of ceftriaxone with 5-nitroimidazole (e.g. omidazole) 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, but in case of pre-terminal renal failure (creatinine clearance <10 mL/min) the dosage should not exceed 2 g (potency) 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 dysfunction, the plasma concentration of ceftriaxone should be determined at require intervals. In patients undergoing dialysis, no additional supplementary dosing is required following the dialysis. Serum concentrations should be monitored, however, to determine whether dosage adjustments are necessary, since the elimination rate in these patients may be reduced.
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.
