From the Guidelines
Ceftriaxone is a recommended empirical treatment for urinary tract infections (UTIs), particularly for patients who require intravenous therapy, due to its efficacy and low resistance rates, as stated in the 2024 guidelines for the prevention, diagnosis, and management of urinary tract infections 1. When considering the use of ceftriaxone for UTIs, it's essential to note that it is typically reserved for more serious infections or when oral antibiotics are not appropriate. The dosage of ceftriaxone for UTIs is usually 1-2 grams once daily, either intravenously or intramuscularly, for 7-14 days depending on infection severity. Ceftriaxone works well against many gram-negative bacteria that commonly cause UTIs, including Escherichia coli, Klebsiella, and Proteus species. Some key points to consider when using ceftriaxone for UTIs include:
- Ceftriaxone is a third-generation cephalosporin antibiotic that inhibits bacterial cell wall synthesis, leading to cell death.
- For simple, uncomplicated UTIs, oral antibiotics like nitrofurantoin, trimethoprim-sulfamethoxazole, or fosfomycin are usually preferred first-line options.
- Patients should complete the full course of antibiotics even if symptoms improve before completion to prevent recurrence and antibiotic resistance.
- The European Association of Urology guidelines also recommend the use of intravenous third-generation cephalosporins, such as ceftriaxone, as empirical treatment for complicated UTI with systemic symptoms 1.
From the FDA Drug Label
URINARY TRACT INFECTIONS (complicated and uncomplicated) Caused by Escherichia coli, Proteus mirabilis, Proteus vulgaris, Morganella morganii or Klebsiella pneumoniae Ceftriaxone is effective for treating urinary tract infections (UTIs) caused by susceptible organisms, including:
- Escherichia coli
- Proteus mirabilis
- Proteus vulgaris
- Morganella morganii
- Klebsiella pneumoniae 2
From the Research
Efficacy of Ceftriaxone for UTI
- Ceftriaxone has been shown to be effective in treating urinary tract infections (UTIs) in several studies 3, 4, 5, 6, 7.
- The drug has a broad spectrum of activity against Gram-positive and Gram-negative aerobic, and some anaerobic, bacteria, making it suitable for treating UTIs caused by various pathogens 5.
- Studies have demonstrated that ceftriaxone achieves high levels in urine and proximate tissue following single daily doses, leading to excellent clinical and bacteriologic results in infections due to susceptible organisms 6.
Comparison with Other Antibiotics
- Ceftriaxone has been compared to other antibiotics, such as cefazolin and cefotetan, in the treatment of UTIs, and has been found to be similarly efficacious or even more effective in some cases 4, 7.
- The drug's long half-life allows for once-daily administration, which can result in convenience and cost benefits 5.