Does Rocephin (Ceftriaxone) cover Gram-negative rods?

From the Guidelines

Yes, Rocephin (Ceftriaxone) is effective against many Gram-negative rods, including Enterobacteriaceae, as evidenced by a multicenter, randomized study where ceftriaxone 1 g once daily was equivalent to ertapenem 1 g once daily for CAP due to Enterobacteriaceae, including Klebsiella species, E. coli, or Enterobacter 1. As a third-generation cephalosporin, it has excellent activity against common gram-negative pathogens including Escherichia coli, Klebsiella pneumoniae, Proteus species, Haemophilus influenzae, Neisseria gonorrhoeae, and many Enterobacteriaceae. Key points to consider when using Rocephin for Gram-negative rod coverage include:

• The typical adult dose is 1-2 grams intravenously or intramuscularly once daily, with treatment duration varying based on the infection type (typically 5-14 days) 1.
• Rocephin works by binding to penicillin-binding proteins in bacterial cell walls, disrupting cell wall synthesis and causing bacterial cell death.
• However, it has limited activity against Pseudomonas aeruginosa and is not effective against extended-spectrum beta-lactamase (ESBL) producing organisms or carbapenem-resistant Enterobacteriaceae.
• For these resistant organisms, alternative antibiotics like carbapenems, aminoglycosides, or polymyxins may be necessary.
• Rocephin also provides coverage against many gram-positive organisms, making it a versatile choice for empiric therapy in many clinical scenarios. Some important considerations for the use of Rocephin include:
• Monitoring for signs of resistance or treatment failure, particularly in patients with risk factors for resistant organisms.
• Adjusting the treatment regimen as needed based on culture and susceptibility results.
• Considering alternative therapies for patients with severe infections or those who are at high risk for treatment failure.

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 Caused by ... Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Escherichia coli, Enterobacter aerogenes, Proteus mirabilis or Serratia marcescens SKIN AND SKIN STRUCTURE INFECTIONS Caused by ... Escherichia coli, Enterobacter cloacae, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Morganella morganii, Pseudomonas aeruginosa, Serratia marcescens URINARY TRACT INFECTIONS (complicated and uncomplicated) Caused by Escherichia coli, Proteus mirabilis, Proteus vulgaris, Morganella morganii or Klebsiella pneumoniae BACTERIAL SEPTICEMIA Caused by ... Escherichia coli, Haemophilus influenzae or Klebsiella pneumoniae BONE AND JOINT INFECTIONS Caused by ... Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae or Enterobacter species INTRA-ABDOMINAL INFECTIONS Caused by Escherichia coli, Klebsiella pneumoniae MENINGITIS Caused by Haemophilus influenzae, Neisseria meningitidis Ceftriaxone for Injection has also been used successfully in a limited number of cases of meningitis and shunt infection caused by ... Escherichia coli

Yes, Rocephin (Ceftriaxone) covers Gram-negative rods, including:

• Haemophilus influenzae
• Haemophilus parainfluenzae
• Klebsiella pneumoniae
• Escherichia coli
• Enterobacter aerogenes
• Proteus mirabilis
• Serratia marcescens
• Enterobacter species 2

From the Research

Coverage of Gram-Negative Rods by Rocephin (Ceftriaxone)

• Rocephin (Ceftriaxone) has a broad spectrum of activity against Gram-positive and Gram-negative aerobic, and some anaerobic, bacteria 3.
• The activity of ceftriaxone is generally greater than that of the 'first' and 'second generation' cephalosporins against Gram-negative bacteria 3.
• Ceftriaxone possesses excellent activity against many Gram-negative aerobic bacilli, including:
  • Escherichia coli
  • Species of Proteus, Klebsiella, Morganella, Providencia, and Citrobacter
  • Enterobacter agglomerans 4.
• Ceftriaxone has been effective in treating infections due to multidrug-resistant Enterobacteriaceae 3.
• However, ceftriaxone resistance among some Gram-negative species, such as Enterobacter cloacae and Acinetobacter spp., has been reported 5.
• Despite this, ceftriaxone has retained its potent activity against the most commonly encountered Gram-positive and Gram-negative human pathogens 5.

Specific Gram-Negative Rods Covered by Ceftriaxone

• Escherichia coli: ceftriaxone resistance is low and consistent, ranging from 0.2-0.4% 5.
• Klebsiella oxytoca: ceftriaxone resistance ranges from 3.5-4.8% 5.
• Klebsiella pneumoniae: ceftriaxone resistance ranges from 1.9-2.6% 5.
• Proteus mirabilis: ceftriaxone resistance is low, ranging from 0.2-0.3% 5.
• Morganella morganii: ceftriaxone resistance ranges from 0.3-2.1% 5.
• Serratia marcescens: ceftriaxone resistance ranges from 1.6-3.8% 5.
• Haemophilus influenzae: all isolates are susceptible to ceftriaxone 5.
• Neisseria gonorrhoeae: all isolates are susceptible to ceftriaxone 5.
• Moraxella catarrhalis: 99.7% of isolates are susceptible to ceftriaxone 5.