Monocef (Ceftriaxone) Dosing for a 38 kg Child
For a 38 kg child, the recommended dose of Monocef (Ceftriaxone) is 50-75 mg/kg/day given once daily or divided every 12-24 hours, which equals 1900-2850 mg/day, not to exceed 2 grams per day for most infections. 1
Dosing Based on Indication
- For less severe infections: 50-75 mg/kg/day given once daily or divided every 12-24 hours (1900-2850 mg/day), not to exceed 2 grams daily 2, 1
- For severe infections including pneumonia: 50-100 mg/kg/day given once daily or divided every 12-24 hours (1900-3800 mg/day), not to exceed 2 grams daily for most infections 2
- For bacterial meningitis: 100 mg/kg/day divided every 12-24 hours (3800 mg/day), not to exceed 4 grams daily 2, 1
- For skin and skin structure infections: 50-75 mg/kg/day given once daily or divided twice a day (1900-2850 mg/day), not to exceed 2 grams daily 1
- For acute bacterial otitis media: A single intramuscular dose of 50 mg/kg (1900 mg), not to exceed 1 gram 1
Pathogen-Specific Dosing
- For Streptococcus pneumoniae with penicillin MIC <2.0 μg/mL: 50-100 mg/kg/day every 12-24 hours (1900-3800 mg/day) 3
- For penicillin-resistant Streptococcus pneumoniae (MIC ≥4.0 μg/mL): 100 mg/kg/day every 12-24 hours (3800 mg/day) 3
- For Group A Streptococcus: 50-100 mg/kg/day every 12-24 hours (1900-3800 mg/day) 3
- For Haemophilus influenzae (β-lactamase producing): 50-100 mg/kg/day every 12-24 hours (1900-3800 mg/day) 3
Administration Guidelines
- Intravenous doses should be administered over 30 minutes 1
- For intramuscular administration, reconstitute with appropriate diluent and inject well within the body of a relatively large muscle 1
- Duration of therapy is typically 4-14 days; for complicated infections, longer therapy may be required 1
- When treating Streptococcus pyogenes infections, therapy should be continued for at least 10 days 1
Important Considerations
- No dosage adjustment is necessary for patients with impairment of renal or hepatic function 1
- Do not use diluents containing calcium, such as Ringer's solution or Hartmann's solution, to reconstitute ceftriaxone 1
- Once-daily administration of ceftriaxone at 50-80 mg/kg has been shown to be effective for serious bacterial infections in children with a clinical cure rate of 94% 4
- For patients with an estimated glomerular filtration rate of >80 mL/min/1.73 m² or in areas with less-susceptible pathogens, a twice-daily dosing regimen of 50 mg/kg (1900 mg twice daily for this 38 kg child) may improve target attainment 5
Clinical Evidence Support
- Studies have shown that ceftriaxone trough levels with once-daily dosing of 50 mg/kg exceeded the MIC of most infecting organisms, supporting the efficacy of once-daily dosing 6
- Single-dose pharmacokinetic studies in pediatric patients with CNS infections have demonstrated adequate CSF penetration of ceftriaxone, with concentrations exceeding the MICs of causative bacteria by hundreds to thousands of times 7