From the Guidelines
For the treatment of acute bacterial sinusitis, a single 50-mg/kg dose of ceftriaxone, given intramuscularly, can be used for children who are vomiting, unable to tolerate oral medication, or unlikely to be adherent to the initial doses of antibiotic 1.
Key Considerations
- Ceftriaxone is a third-generation cephalosporin effective against many respiratory pathogens, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
- The 3 major bacterial pathogens involved in acute bacterial sinusitis are susceptible to ceftriaxone in 95% to 100% of cases 1.
- If clinical improvement is observed at 24 hours, an oral antibiotic can be substituted to complete the course of therapy.
Administration and Duration
- Ceftriaxone should be reconstituted according to manufacturer instructions and injected deeply into a large muscle mass.
- Treatment duration typically ranges from 5-7 days for acute bacterial sinusitis, though this may be extended to 10-14 days in severe cases or those with complicating factors.
Important Notes
- Parenteral therapy with ceftriaxone is generally reserved for patients with severe sinusitis, treatment failures, immunocompromised status, or those unable to tolerate oral antibiotics.
- Most uncomplicated sinusitis cases are treated with oral antibiotics as first-line therapy.
- The choice of antibiotic should consider local patterns of susceptibility and resistance, as well as patient-specific factors such as allergy history and recent antibiotic use 1.
From the Research
Dosage of Ceftriaxone (IM) for Sinusitis
- The dosage of Ceftriaxone (IM) for sinusitis is 1 g intramuscular injection once daily 2.
- This dosage was found to be effective in the treatment of acute bacterial sinusitis, with significant cure response observed in Ceftriaxone treated patients compared to those treated with Amoxicillin-clavulanic acid 2.
- The study compared the efficiency of Ceftriaxone versus Amoxicillin-clavulanic acid for the treatment of acute bacterial rhinosinusitis and found Ceftriaxone to be more effective 2.
Comparison with Other Antibiotics
- Other studies have compared the efficacy of different antibiotics, such as Azithromycin and Amoxicillin-clavulanic acid, in the treatment of acute sinusitis 3, 4, 5.
- These studies found that Azithromycin was as effective as Amoxicillin-clavulanic acid in the treatment of acute sinusitis, with a simpler dosage regimen and faster clinical effect 4, 5.
- However, the dosage of Ceftriaxone (IM) for sinusitis was not directly compared with these antibiotics in the provided studies.
Limitations
- The provided studies do not offer a direct comparison of Ceftriaxone (IM) with other antibiotics, such as Azithromycin, in the treatment of sinusitis.
- Further studies would be needed to determine the optimal dosage and efficacy of Ceftriaxone (IM) compared to other antibiotics for the treatment of sinusitis.