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Mesporin

Ceftriaxone (in the form of sodium ceftriaxone)

Lidocaine chlorhydrate
 

Clinical Information
Therapeutic Indications

Ceftriaxone is used in the treatment of lower respiratory tract infections, skin and its structures infections, bone and joint infections, intra-abdominal infections, urinary tract infections, meningitis, septicaemia and provoked gonorrhoea. Ceftriaxone is also used for peri-surgery prophylaxis.


Due to the fact that, ceftriaxone has a prolongated half-life and can be used once daily, some clinicians suggest this drug can be useful in the treatment of infections caused by susceptible microorganisms, that require prolongated therapy in ambulatory patients (osteomyelitis). Ceftriaxone has been used successfully in the treatment of adults and children in ambulatory, in some cases the drug was self-administrated. Before initiating the therapy with ceftriaxone, the adequate samples should be collected to identify the causative microorganism and study in vitro sensitivity. Therapy with ceftriaxone can be initiated while waiting for the sensitivity tests results, but should be interrupted if the microorganism demonstrates resistance to this antibiotic.


Bacterial Infections caused by Gram-positive Aerobics
In general ceftriaxone has been effective in adults and children in the treatment of skin cutaneous structures infections, pneumonia, urinary tract infections, bone and joint infections or septicaemia caused by sensitive Gram-positive coccus (Staphylococcus aureus, Streptococci from groups A and B, Streptococcus pneumoniae). However, many clinicians share the opinion that ceftriaxone, like other 3rd generation cephalosporins , should not be used in the treatment of infections caused by Gram-positive bacteria when penicillin or 1st generation cephalosporins can be used.


Bacterial Infections caused by Gram-negative Aerobics
Ceftriaxone is used in the treatment of lower respiratory tract infections caused by: Haemophilus influenza, Haemophilus parainfluenza, Enterobacter xerogenes, Escherichia coli, Klebsiella (including K. Pneumoniae), Proteus mirabilis or Serratia marcescens; Skin and cutaneous infections caused by E. cloacae, Klebsiella (including K. Pneumoniae, K. oxytroca), P mirabilis, Morganella morganii, E. coil, Serratia marcescens, Acinetobacter calcoaceticus or Pseudomonas aeruginosa; bone and joint infections caused by Enterobacter, E. coli, K. Pneumoniae, P mirabilis, urinary tract infections caused by E. coli, Kiebsielia (including K. Pneumoniae), Morganella morganii, P mirabilis or P vulgaris, infra-abdominal infections caused by E. coli or K. Pneumoniae; non-complicated gonorrhoea or pelvic inflammatory disease (PID) caused by Neisseria gonorrhoeae; septicaemia caused by E. coil, H. influenza or K. Pneumoniae.

 

Third generation cephalosporins have been used together with aminoglycosids in the empirical treatment of patients with severe Gram-negative sepsis.


Cancroid
A dose of 250 mg IM of ceftriaxone is effective in the treatment of genital ulcers caused by H. ducreyi and is recommended as an alternative to erythromycin in this infection treatment, in patients infected by the Human Immunodeficiency Virus (HIV).


Bacterial Infections caused by Enterobacteriacea
Ceftiaxone and other 3rd generation cephalosporins, are as effective as aminoglycosids in the treatment of these infections and are associated to less toxicity. In the begining of severe infections caused by Enterobacteriacea, many clinicians suggest that 3rd generation cephalosporins and a large spectrum penicillin should be used together with an aminoglycosid until the sensitivity tests results are known. Some clinicians even suggest that ceftriaxone is specially useful as initial therapy in the treatment of infections known or suspected to be caused by multi-resistant Enterobacteriacea (pneumonia or nosocomial infections of urinary tract, septicaemia suspects in neutopenic patients). However, for the treatment of urinary tract infections without complications, ceftriaxone use (like other 3rd generation cephalosporins) should not be generalized, when are available small activity spectrum antibiotics, considered the first choice.


Otitis media
A clinical trial results, randomised and double blind suggest that a single dose of 50 mg/kg of ceftriaxone IM has an equal efficacy to 40 mg/kg of amoxicillin during 10 days, in the treatment of odds media in children between 5 months and 5 years of age. A single dose of ceftriaxone IM can therefore, be an alternative to oral antibiotics in the treatment of otitis media, especially in cases where acceptance/collaboraton, from the patient can be a problem.


Gonorrhoea and Associated Infections
Ceftriaxone is used in the treatment of non-complicated gonorrhea, as well as other gonococcic infections caused by strains that produce penicillinases of N. gonorrhoeae (PPNG) or strains that do not produce penicillinases of this microorganism. Ceftriaxone is considered as a first choice drug in the treatment of endocervical or rectum uretral infections caused by N. gonorrhoeae, as well as other gonococcic infections caused by PPNG.


Non-complicated Gonorrhoea in Adults
A single dose of ceftriaxone IM is one of various therapeutic regimens effective in the treatment of uretral, endocervical, pharynge or rectal infections caused by N. gonorrhoeae penicillinase producer or not. A single doses of 125-250 mg of ceftriaxone IM is recommended for the treatment of non-complicated gonorrhoea, associated to an anti-infection regimen effective in Chlamydia infection. Up to now, there are no known strains of N. gonorrhoeae resistant to ceftriaxone.


Disseminated Gonococcic Infections in Adults
Ceftriaxone IM and IV is recommended as the elective regimen in the initial treatment of disseminated gonococcic infection (syndrome of dermatitis-gonococcic arthritis).


Gonococcic Ophtalmia in Adults
Ceftriaxone IM is recommended for the treatment of gonococcic ophtalmia treatment in the adult. It should be considered the risk of ophtalmic infection with C. trachomatis, especially in the patients that did not respond to ceftriaxone therapy.


Epididymitis
A single dose of 250 mg of ceftriaxone IM associated td oral doxicyclin or tetacyclin orais, in adults, in the treatment of acute epididymitis, sexually transmitted and caused by N. gonorrhoeae and/or C. trachomatis.

 

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