Rocephin (Ceftriaxone) Dosing for Infectious Colitis
For infectious colitis, the recommended dose of Rocephin (ceftriaxone) is 1-2 grams intravenously every 24 hours until clinical improvement, typically for 5-7 days.
Dosing Considerations
Adult Dosing
- Standard dose: 1-2 grams IV once daily 1
- For severe infections: Consider 2 grams IV once daily 2
- Duration: Continue until clinical improvement (typically 5-7 days)
Pediatric Dosing
- For children: 50-75 mg/kg/day IV once daily (not to exceed 2 grams/day) 1, 2
- For severe infections in children: 100 mg/kg/day (not to exceed 4 grams/day) 1, 2
Administration Guidelines
- Intravenous administration should be given over 30 minutes 2
- For intramuscular administration (if IV access unavailable):
- Reconstitute with appropriate diluent
- Inject well within a relatively large muscle 2
- Do not use diluents containing calcium (e.g., Ringer's solution) due to risk of precipitation 2
Special Populations
Renal/Hepatic Impairment
- No dosage adjustment is necessary for patients with renal or hepatic impairment for doses up to 2 grams per day 2, 3
- For patients on dialysis, monitor plasma concentrations as elimination rate may be reduced in a small percentage of patients 3
Elderly Patients
- No dosage modification required for elderly patients (up to 2 grams per day) in the absence of severe renal or hepatic impairment 2
Clinical Considerations
Antimicrobial Coverage
- Ceftriaxone provides excellent coverage against most Enterobacteriaceae, which are common causes of infectious colitis 4
- For suspected or confirmed colitis caused by Clostridium difficile, ceftriaxone is NOT appropriate; use oral vancomycin or fidaxomicin instead
Concurrent Infections
- If Chlamydia trachomatis is a suspected pathogen, appropriate antichlamydial coverage should be added (e.g., doxycycline), as ceftriaxone has no activity against this organism 2
Duration of Therapy
- Generally, ceftriaxone therapy should be continued for at least 2 days after signs and symptoms of infection have disappeared 2
- The usual duration of therapy for most infections is 4-14 days; in complicated infections, longer therapy may be required 2
Potential Pitfalls
- Avoid simultaneous administration with calcium-containing IV solutions 2
- Ceftriaxone should be used cautiously in hyperbilirubinemic infants, especially premature ones 5, 2
- Do not use ceftriaxone in neonates (≤28 days) if they require calcium-containing IV solutions 2
- Monitor for superinfection, particularly C. difficile-associated diarrhea, which can occur during or after treatment
Follow-up
- Assess clinical response within 48-72 hours
- Consider switching to oral therapy once clinical improvement occurs and patient can tolerate oral medications
- Complete the full course of antibiotics even if symptoms improve before completion