From the Guidelines
Ceftriaxone 250 mg IM is primarily indicated for the treatment of uncomplicated gonorrhea in adults, as part of a combination therapy with a single dose of azithromycin 1 g orally or doxycycline 100 mg orally twice daily for 7 days. This single-dose regimen is effective against Neisseria gonorrhoeae infections of the cervix, urethra, rectum, and pharynx 1. When administering ceftriaxone IM, it should be injected deep into a large muscle mass such as the gluteal muscle or lateral thigh, and the injection sites should be rotated if multiple doses are needed. The medication should be reconstituted according to manufacturer instructions, typically with 1% lidocaine to reduce injection pain. Ceftriaxone works by inhibiting bacterial cell wall synthesis, leading to cell death. It's worth noting that while 250 mg was previously considered, current guidelines often recommend this dose as part of combination therapy for uncomplicated gonorrhea, with higher doses (500 mg or 1 gram) recommended for more complicated cases or due to emerging resistance patterns 1. Patients should be tested for other sexually transmitted infections, particularly chlamydia, which often co-occurs with gonorrhea and requires additional treatment. Patients should also abstain from sexual activity until treatment is complete and partners have been treated to prevent reinfection. Key points to consider include:
- The use of ceftriaxone in combination with other antibiotics for the treatment of gonorrhea 1
- The importance of testing for other sexually transmitted infections, such as chlamydia 1
- The need for patients to abstain from sexual activity until treatment is complete and partners have been treated to prevent reinfection 1
From the FDA Drug Label
For the treatment of uncomplicated gonococcal infections, a single intramuscular dose of 250 mg is recommended. The indication for 250 mg Ceftriaxone Intramuscularly (IM) is for the treatment of uncomplicated gonococcal infections 2.
From the Research
Indication for 250 mg Ceftriaxone IM
- The indication for 250 mg Ceftriaxone Intramuscularly (IM) is for the treatment of uncomplicated gonorrhea, including urethral, cervical, pharyngeal, and anal infections 3, 4, 5, 6, 7.
- Ceftriaxone is effective against both beta-lactamase-positive and -negative strains of Neisseria gonorrhoeae, making it a suitable treatment option for gonorrhea, particularly where penicillinase-producing N. gonorrhoeae is prevalent 5.
- The cure rates for 250 mg Ceftriaxone IM are high, ranging from 95% to 100% in various studies, with some studies showing similar efficacy to other treatment regimens such as cefixime and ceftizoxime 3, 4.
- Ceftriaxone is also effective in treating gonococcal infections in men and women, with high cure rates and minimal adverse events reported 6, 7.
Specific Uses
- Uncomplicated urethral gonorrhea: 250 mg Ceftriaxone IM is recommended as a single-dose treatment regimen 4.
- Uncomplicated cervical gonorrhea: 250 mg Ceftriaxone IM is effective in treating cervical gonorrhea, with high cure rates reported 3, 7.
- Pharyngeal and anal gonorrhea: 250 mg Ceftriaxone IM is also effective in treating pharyngeal and anal gonorrhea, with high cure rates reported 3, 5.