Why is Rocephin (Ceftriaxone) used for bacterial infections?

From the Guidelines

Rocephin (ceftriaxone) is used for bacterial infections because it is a powerful third-generation cephalosporin antibiotic that effectively kills a wide range of bacteria, with a broad spectrum of activity against many gram-positive and gram-negative bacteria, including those that cause respiratory infections, urinary tract infections, meningitis, gonorrhea, and many other serious infections, as supported by the most recent study from 2021 1.

Key Points

• Rocephin works by inhibiting bacterial cell wall synthesis, causing the bacteria to weaken and die.
• The medication is typically administered as an injection, either intravenously or intramuscularly, with dosages ranging from 1-2 grams daily for adults (adjusted for children based on weight) for 1-14 days depending on the infection type and severity.
• Rocephin's long half-life allows for convenient once-daily dosing, improving patient compliance.
• It also penetrates well into various tissues and body fluids, including cerebrospinal fluid, making it effective for treating infections throughout the body.
• Patients should be aware that allergic reactions can occur, especially in those with penicillin allergies, and should report any rash, itching, or difficulty breathing immediately.

Evidence

• A study from 2021 1 compared ceftaroline, a fifth-generation cephalosporin, with ceftriaxone in patients with severe pneumonia, and found that ceftaroline was superior to ceftriaxone in an intention to treat analysis.
• Another study from 2018 1 recommended ceftriaxone as a treatment option for spontaneous bacterial peritonitis, with a resolution rate of 73-100%.
• The 2006 study 1 provided guidelines for the treatment of Lyme disease, and recommended ceftriaxone as a preferred parenteral regimen, with a dosage of 2 g intravenously once per day for adults.

Important Considerations

• The choice of antibiotic should be based on the severity of the infection, the suspected causative pathogen, and the patient's medical history and allergies.
• Patients with severe infections, such as septic shock, may require more aggressive treatment, including the use of adjunctive corticosteroids, as suggested by the 2021 study 1.
• The treatment duration and dosage of Rocephin should be adjusted according to the patient's response to treatment and the results of antimicrobial susceptibility testing.

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 ACUTE BACTERIAL OTITIS MEDIA SKIN AND SKIN STRUCTURE INFECTIONS URINARY TRACT INFECTIONS (complicated and uncomplicated) UNCOMPLICATED GONORRHEA (cervical/urethral and rectal) PELVIC INFLAMMATORY DISEASE BACTERIAL SEPTICEMIA BONE AND JOINT INFECTIONS INTRA-ABDOMINAL INFECTIONS MENINGITIS

Rocephin (Ceftriaxone) is used for bacterial infections because it is effective against a wide range of susceptible bacteria that cause various types of infections, including:

• Lower respiratory tract infections
• Acute bacterial otitis media
• Skin and skin structure infections
• Urinary tract infections
• Uncomplicated gonorrhea
• Pelvic inflammatory disease
• Bacterial septicemia
• Bone and joint infections
• Intra-abdominal infections
• Meningitis 2

From the Research

Mechanism of Action

• Ceftriaxone is a third-generation cephalosporin with broad-spectrum in vitro activity against Gram-positive and Gram-negative aerobic, and some anaerobic, bacteria 3, 4, 5
• It has a long serum half-life, which allows for once-daily administration in most adults and every 12 hours in children 6, 4, 5

Efficacy

• Ceftriaxone has been shown to be effective in treating various types of infections, including:
  • Skin and soft tissue infections 3, 6, 4, 5
  • Urinary tract infections 3, 4, 5, 7
  • Lower respiratory tract infections 3, 4, 5, 7
  • Bacteremia/septicaemia 3, 4, 5
  • Paediatric meningitis 4, 7
  • Gonorrhoea 4, 5, 7
• The response rate to ceftriaxone has been reported to be around 90% in various studies 3, 5

Safety and Tolerability

• Ceftriaxone is generally well tolerated, with few serious drug toxicities reported 3, 4, 5, 7
• Adverse reactions characteristic of cephalosporins have been observed, but no unique toxicities have been identified 5
• Hypoprothrombinemic bleeding is not part of the adverse reaction profile of ceftriaxone 5