What STIs (Sexually Transmitted Infections) is Rocephin (ceftriaxone) effective against?

Rocephin (Ceftriaxone) Coverage for Sexually Transmitted Infections

Rocephin (ceftriaxone) is primarily effective against gonorrhea (Neisseria gonorrhoeae), including both penicillinase-producing and non-penicillinase-producing strains, and is considered first-line therapy for this STI. 1

Effectiveness Against Specific STIs

Highly Effective For:

• Neisseria gonorrhoeae (Gonorrhea)
  • Effective for urethral, cervical, rectal, and pharyngeal infections 2
  • Cure rates of 98.9% for uncomplicated urogenital and anorectal infections 2
  • Effective against penicillinase-producing strains (PPNG) 3
  • Superior effectiveness for pharyngeal gonorrhea (94% cure rate) compared to other treatments 4

Not Effective Against:

• Chlamydia trachomatis
  • Ceftriaxone has no activity against Chlamydia 1
  • When treating gonorrhea, co-treatment for chlamydia is recommended if not ruled out 2
• Other STIs
  • Not effective against viral STIs (herpes, HPV, HIV)
  • Not indicated for syphilis as primary treatment, though it may incidentally abort incubating syphilis 2

Dosing Recommendations

• For uncomplicated gonorrhea:
  • 125-250 mg IM in a single dose 2, 5
  • Higher doses (1g) may be used in certain situations 5

Important Clinical Considerations

1. Resistance Patterns

   • No ceftriaxone-resistant strains of N. gonorrhoeae were reported in earlier guidelines 2
   • However, surveillance for antimicrobial resistance is crucial as resistance patterns evolve 2

2. Co-infection Management

   • Always add treatment for chlamydia if not ruled out, typically:
     • Doxycycline 100 mg orally twice daily for 7 days, OR
     • Azithromycin 1 g orally in a single dose 2

3. Advantages of Ceftriaxone

   • High efficacy against all anatomical sites of gonococcal infection
   • Effective against resistant strains
   • Provides sustained, high bactericidal levels in the blood 2

4. Limitations

   • Must be administered by injection
   • More expensive than some alternatives
   • Not active against Chlamydia trachomatis 1

Special Populations

• Pharyngeal Gonorrhea

  • Ceftriaxone is particularly effective for pharyngeal infections (94% cure rate) 4
  • Preferred over oral cephalosporins for pharyngeal gonorrhea 2

• MSM and High-Risk Groups

  • Ceftriaxone is recommended for men who have sex with men (MSM) and those with history of travel to areas with high resistance rates 2

In summary, while Rocephin (ceftriaxone) is highly effective against gonorrhea, it must be combined with appropriate therapy for chlamydia in most cases, as co-infection is common and ceftriaxone has no activity against chlamydial infections.