Ceftriaxone Dosing for Typhoid Fever in a 14-Year-Old Female (44kg)
For a 14-year-old female weighing 44kg with confirmed typhoid fever, the recommended dose of ceftriaxone is 50-75 mg/kg/day given once daily or divided into two doses, which equals 2200-3300 mg/day, with a maximum daily dose of 4 grams. 1
Dosing Calculation and Administration
Based on the patient's weight of 44kg:
- At 50 mg/kg/day: 44kg × 50 mg/kg = 2200 mg (2.2g) daily
- At 75 mg/kg/day: 44kg × 75 mg/kg = 3300 mg (3.3g) daily
Administration options:
- Once daily dosing: 2200-3300 mg IV once daily
- Divided dosing: 1100-1650 mg IV every 12 hours
The FDA-approved ceftriaxone label indicates that for serious infections other than meningitis in pediatric patients, the recommended total daily dose is 50-75 mg/kg, given in divided doses every 12 hours, with a total daily dose not exceeding 2 grams 2. However, for typhoid fever specifically, higher dosing may be appropriate.
Duration of Therapy
The World Health Organization recommends ceftriaxone at 80 mg/kg daily for 5-7 days for typhoid fever 1.
Research evidence supports various durations:
Important Clinical Considerations
Monitor for clinical response within 48-72 hours of treatment initiation.
Signs of improvement include decreased fever, improved appetite, and reduced abdominal symptoms.
If no clinical improvement is observed within 48-72 hours, reassess diagnosis and consider alternative antibiotics.
Common side effects of ceftriaxone include:
- Gastrointestinal disturbances
- Transient elevation in liver enzymes
- Local pain at injection site
Precautions
Avoid ceftriaxone in patients with hypersensitivity to cephalosporins.
Do not use diluents containing calcium (such as Ringer's solution) to reconstitute ceftriaxone due to risk of particulate formation 2.
For IV administration, infuse over 30 minutes in pediatric patients 2.
Follow-up Recommendations
Obtain blood cultures after completion of therapy to ensure eradication of Salmonella typhi.
Assess for clinical cure and monitor for potential relapse for 1-2 months after treatment.
Screen for carrier state if clinically indicated, particularly if the patient works in food handling or healthcare.
The evidence strongly supports ceftriaxone as an effective treatment for typhoid fever with high cure rates, rapid clinical response, and low relapse rates 5, 3, 4.