From the Guidelines
The recommended dosage of intravenous (IV) ceftriaxone for inpatients is 2 grams administered every 12 hours, with a duration of therapy ranging from 10 to 14 days depending on the type and severity of infection, as supported by the UK Joint Specialist Societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults 1.
Key Considerations
- The dosage and duration of IV ceftriaxone may vary based on the specific infection being treated, with pneumococcal meningitis requiring 10-14 days of treatment 1.
- For patients with confirmed pneumococcal meningitis who have recovered by day 10, treatment should be stopped, while those who have not recovered by day 10 should receive 14 days of treatment 1.
- The use of IV ceftriaxone in combination with other antibiotics, such as vancomycin and rifampicin, may be necessary for patients with penicillin and cephalosporin-resistant pneumococcal meningitis 1.
Dosage and Administration
- The recommended dosage of IV ceftriaxone is 2 grams every 12 hours, with a maximum daily dose of 4 grams 1.
- Once-daily dosing of IV ceftriaxone may be possible after the first 24 hours of therapy, but twice-daily dosing is recommended in the initial 24 hours to achieve rapid CSF sterilization 1.
Special Considerations
- Pediatric patients may require a different dosage of IV ceftriaxone, with a recommended dosage of 50-100 mg/kg/day, not exceeding 4 grams daily.
- Patients with renal impairment may not require dosage adjustments, but caution is warranted in patients with both hepatic and renal dysfunction.
From the FDA Drug Label
The usual adult daily dose is 1 to 2 grams given once a day (or in equally divided doses twice a day) depending on the type and severity of infection. The total daily dose should not exceed 4 grams. Generally, ceftriaxone for injection therapy should be continued for at least 2 days after the signs and symptoms of infection have disappeared The usual duration of therapy is 4 to 14 days; in complicated infections, longer therapy may be required.
The recommended dosage of IV ceftriaxone for inpatients is 1 to 2 grams per day, and the recommended duration of therapy is 4 to 14 days 2.
- The dose may be given once a day or in equally divided doses twice a day.
- The total daily dose should not exceed 4 grams.
- Therapy should be continued for at least 2 days after the signs and symptoms of infection have disappeared.
From the Research
Dosage of IV Ceftriaxone for Inpatients
- The recommended dosage of IV ceftriaxone for inpatients varies depending on the specific infection being treated and the patient's individual needs 3, 4, 5.
- For community-acquired pneumonia, studies suggest that a dosage of 1 g daily is as effective as 2 g daily, with similar clinical outcomes and lower rates of Clostridioides difficile infection (CDI) 3, 4.
- However, for intensive care unit (ICU) patients, a dosage of 2 g daily may be associated with reduced treatment failure and improved clinical outcomes 5.
Duration of IV Ceftriaxone for Inpatients
- The duration of IV ceftriaxone therapy for inpatients depends on the specific infection being treated and the patient's response to treatment 3, 4, 5.
- For community-acquired pneumonia, the typical duration of therapy is 5-7 days, but may be longer or shorter depending on the patient's individual needs and response to treatment 3, 4.
- For ICU patients, the duration of therapy may be longer, typically 7-10 days or more, depending on the severity of the infection and the patient's response to treatment 5.
Specific Considerations
- For patients with methicillin-susceptible Staphylococcus aureus (MSSA) pneumonia, ceftriaxone may not be the ideal agent, as it has been associated with higher clinical failure rates compared to ceftaroline or ceftobiprole 6.
- Patients with penicillin or ceftriaxone-resistant Streptococcus pneumoniae may require alternative antibiotic therapy 4.