From the Guidelines
When converting from Rocephin (ceftriaxone) to an oral antibiotic, cefpodoxime proxetil is a suitable option due to its similar activity against respiratory pathogens, as noted in the antimicrobial treatment guidelines for acute bacterial rhinosinusitis 1. This is because cefpodoxime proxetil, a third-generation oral cephalosporin, has a spectrum of activity similar to that of cefuroxime axetil and cefdinir against S pneumoniae, but greater against H influenzae, making it a preferred treatment for patients in whom treatment with high-dose amoxicillin or amoxicillin/clavulanate fails or is intolerable 1. Some key points to consider when selecting an oral antibiotic for conversion from ceftriaxone include:
- The specific infection being treated and the organism's susceptibility
- Patient factors, such as ability to tolerate oral medications and functioning gastrointestinal tract
- Local resistance patterns
- The need for broader coverage in more severe infections, which may require options like amoxicillin-clavulanate or a fluoroquinolone such as ciprofloxacin or levofloxacin. It's also important to note that the clinical utility of cefpodoxime proxetil, particularly in children, may be limited by its poor taste in suspension formulation 1. In general, the selection of an oral antibiotic for conversion from ceftriaxone should be guided by the principles of providing similar antimicrobial coverage for the specific infection being treated, while taking into account the patient's individual needs and circumstances.
From the Research
Oral Conversion from Rocephin (Ceftriaxone)
- Rocephin, also known as Ceftriaxone, is a third-generation cephalosporin antibiotic that is typically administered intravenously or intramuscularly 2.
- When considering an oral conversion from Rocephin, cefixime is a potential option, as it is an orally active third-generation cephalosporin with a similar antibacterial activity profile 3, 4, 5.
- Cefixime has been shown to be effective in treating various infections, including lower respiratory tract, ear-nose-throat, and urinary tract infections, and can be used as a step-down therapy after initial treatment with intravenous antibiotics like ceftriaxone 4, 5.
- The dosage of cefixime for oral conversion from Rocephin may vary depending on the specific infection being treated, but a common dosage is 400 mg every 24 hours 4.
- It is essential to note that the decision to convert from intravenous Rocephin to oral cefixime should be based on the patient's clinical response, improvement of symptoms, and presence of normal gastrointestinal tract absorption 4.