Rocephin (Ceftriaxone) Dosing for a 73-Pound Child
For a child weighing 73 pounds (approximately 33 kg), the recommended dose of Rocephin (ceftriaxone) is 50-75 mg/kg/day, which equals 1650-2475 mg per day, typically administered as a single daily dose. 1
Dosing Calculation
The FDA-approved dosing for ceftriaxone in pediatric patients provides clear guidance:
- For most infections: 50-75 mg/kg/day 1
- For meningitis: 100 mg/kg/day (not to exceed 4 grams daily) 1
- Maximum daily dose for non-meningitis infections: 2 grams 1
Weight-based calculation:
- 73 pounds = 33.1 kg
- At 50 mg/kg: 33.1 kg × 50 mg/kg = 1655 mg
- At 75 mg/kg: 33.1 kg × 75 mg/kg = 2482.5 mg
Administration Guidelines
- Ceftriaxone can be administered intravenously (IV) or intramuscularly (IM)
- For IV administration, infuse over 30 minutes 1
- For most infections, once-daily dosing is sufficient and recommended 1, 2
- For meningitis, the total daily dose can be given once daily or divided into two doses 1, 3
Infection-Specific Dosing
Common Infections
- Skin and soft tissue infections: 50-75 mg/kg once daily (not to exceed 2 grams) 1
- Otitis media: 50 mg/kg as a single IM dose (not to exceed 1 gram) 1
- Urinary tract infections, respiratory infections, bone/joint infections: 50-75 mg/kg once daily 1, 4
Severe Infections
- Meningitis: 100 mg/kg once daily (not to exceed 4 grams) 1
- Bacteremia/septicemia: 50-75 mg/kg once daily 1
Duration of Therapy
- Most infections: 4-14 days 1
- Complicated infections may require longer therapy 1
- Streptococcal infections: minimum 10 days 1
- Treatment should generally continue for at least 2 days after signs and symptoms of infection have disappeared 1
Clinical Considerations
- Once-daily dosing has been shown to be as effective as divided doses for most pediatric infections 2
- For critically ill children, the standard 100 mg/kg once-daily dose provides adequate exposure for most susceptible pathogens 5
- For less susceptible pathogens (MIC ≥0.5 mg/L), a twice-daily regimen of 50 mg/kg may improve target attainment 5
Potential Adverse Effects
- Monitor for hypersensitivity reactions
- Use cautiously in patients with history of penicillin allergy (cross-reactivity possible)
- Caution in patients with hepatic or renal impairment
- Common side effects include diarrhea, elevated liver enzymes, and eosinophilia
Monitoring
- Clinical improvement should be assessed within 48-72 hours
- Signs of improvement include decreased fever, improved respiratory status, and improved overall condition
- If no improvement is seen within 48-72 hours, reassessment is necessary
Ceftriaxone's long half-life allows for convenient once-daily dosing in most pediatric infections, which has been demonstrated to be both safe and effective 2.