Can Ceftriaxone (Rocephin) treat Chlamydia?

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Last updated: February 25, 2025View editorial policy

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From the Guidelines

Ceftriaxone (Rocephin) is not the preferred treatment for Chlamydia, and Azithromycin or Doxycycline are the recommended first-line treatments. According to the most recent study 1, the recommended treatment for Chlamydia is Azithromycin 1 g orally, single dose, or Doxycycline 100 mg orally, twice a day for 7 days. Ceftriaxone is more commonly used to treat gonorrhea, which often co-occurs with Chlamydia, and is recommended for children who weigh ≤45 kg with gonococcal conjunctivitis, at a dose of 25–50 mg/kg body weight intravenous or IM, single dose, not to exceed 250 mg IM.

Key Points to Consider

  • The treatment of Chlamydia should prioritize Azithromycin or Doxycycline to minimize morbidity, mortality, and improve quality of life.
  • Ceftriaxone is not the preferred treatment for Chlamydia, but it may be used in certain cases, such as gonococcal conjunctivitis in children.
  • It is essential to get tested and receive the appropriate treatment from a healthcare provider, as untreated Chlamydia can lead to serious complications, including pelvic inflammatory disease and infertility.

Treatment Options

  • Azithromycin 1 g orally, single dose
  • Doxycycline 100 mg orally, twice a day for 7 days
  • Ceftriaxone may be used in certain cases, such as gonococcal conjunctivitis in children, at a dose of 25–50 mg/kg body weight intravenous or IM, single dose, not to exceed 250 mg IM, as recommended by 1.

From the FDA Drug Label

If Chlamydia trachomatis is a suspected pathogen, appropriate antichlamydial coverage should be added, because ceftriaxone sodium has no activity against this organism

  • Ceftriaxone (Rocephin) has no activity against Chlamydia trachomatis
  • It is not recommended for the treatment of Chlamydia infections, and alternative antibiotics with antichlamydial coverage should be used instead 2

From the Research

Ceftriaxone (Rocephin) and Chlamydia Treatment

  • Ceftriaxone is a third-generation cephalosporin effective against various bacterial infections, including gonorrhea 3.
  • However, it is not effective against Chlamydia trachomatis infections 3.
  • Studies have shown that ceftriaxone can be used to treat gonococcal infections, but it does not treat concurrent Chlamydia infections 4, 5, 6.
  • In cases where Chlamydia infection is suspected or confirmed, additional treatment with doxycycline or azithromycin is recommended 4, 5, 6.
  • Ceftriaxone's efficacy in treating gonorrhea does not extend to Chlamydia, and separate treatment is necessary for the latter 7, 3.

Treatment Recommendations

  • For uncomplicated gonococcal infections, a single 500 mg IM dose of ceftriaxone is recommended 4, 5.
  • If Chlamydia infection is not excluded, concurrent treatment with doxycycline (100 mg orally twice a day for 7 days) is advised 4, 5.
  • Ceftriaxone should not be relied upon to treat Chlamydia infections, and specific anti-Chlamydia treatment should be administered separately 3.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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