From the FDA Drug Label
Ceftriaxone for Injection is indicated for the treatment of the following infections when caused by susceptible organisms: LOWER RESPIRATORY TRACT INFECTIONS Caused by Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Escherichia coli, Enterobacter aerogenes, Proteus mirabilis or Serratia marcescens
The treatment for tracheitis (inflammation of the trachea) may include Ceftriaxone for Injection, as it is indicated for the treatment of lower respiratory tract infections caused by susceptible organisms. However, it is essential to note that the drug label does not explicitly mention tracheitis as an indication. 1
From the Research
Tracheitis is treated with a combination of antibiotics, supportive care, and sometimes airway management, with the primary goal of preventing airway obstruction and reducing morbidity and mortality. The treatment approach for tracheitis, particularly bacterial tracheitis, involves the use of broad-spectrum intravenous antibiotics, such as ceftriaxone (50-100 mg/kg/day) plus clindamycin (30-40 mg/kg/day divided every 6-8 hours) or vancomycin (40-60 mg/kg/day divided every 6-8 hours), to cover common pathogens like Staphylococcus aureus, Streptococcus pneumoniae, and others 2.
Key Considerations
- Treatment usually continues for 7-10 days, with the possibility of switching to oral antibiotics once improvement occurs.
- Supportive measures include maintaining hydration, using humidified oxygen for respiratory distress (with oxygen saturation maintained above 92%), and administering acetaminophen or ibuprofen for fever and pain.
- Severe cases may require hospitalization for airway monitoring, as airway obstruction is a serious concern.
- In critical situations, intubation or even tracheostomy might be necessary.
- Viral tracheitis is managed primarily with supportive care, though bacterial superinfection should be monitored for and treated if it develops.
Diagnostic Approach
The diagnosis of bacterial tracheitis should be suspected in a child with toxicity and croup who is not responding to the usual therapy, and endoscopy should be performed to allow for removal of secretions and maintenance of a clear airway 3, 4.
Recent Evidence
A recent study highlighted the importance of early disease identification and urgent surgical intervention in the management of bacterial tracheitis, demonstrating an approach with the potential to improve patient outcomes from this dangerous condition 2.
Pathogens and Treatment
The most common pathogens involved in bacterial tracheitis include Staphylococcus aureus and Haemophilus influenzae, and the treatment approach should be tailored to cover these pathogens 5.
Airway Management
Airway management is critical in the treatment of tracheitis, and the maintenance of a clear airway is the main purpose of the treatment, which may involve endotracheal intubation, humidification, and airway toilet 6.