Ceftriaxone (Rocephin) Dosage for a 3-Year-Old Child
For a 3-year-old child, the recommended dosage of ceftriaxone (Rocephin) is 50-75 mg/kg/day given once daily or divided into two doses, with a maximum daily dose of 2 grams. 1
Dosage Based on Type of Infection
Non-Meningeal Infections
- For skin and skin structure infections: 50-75 mg/kg once daily (or divided twice daily), not to exceed 2 grams total daily dose 1
- For acute bacterial otitis media: Single intramuscular dose of 50 mg/kg (not to exceed 1 gram) 1
- For serious miscellaneous infections: 50-75 mg/kg/day divided every 12 hours, not to exceed 2 grams total daily dose 1
- For pneumonia caused by susceptible pathogens: 50-100 mg/kg/day every 12-24 hours 2, 3
Meningitis
- Initial dose: 100 mg/kg (not to exceed 4 grams) 1
- Maintenance: 100 mg/kg/day (not to exceed 4 grams daily) given once daily or divided every 12 hours 1
- Duration: Usually 7-14 days 1
Pathogen-Specific Dosing
- For Streptococcus pneumoniae with penicillin MIC <2.0 μg/mL: 50-100 mg/kg/day every 12-24 hours 3
- For penicillin-resistant Streptococcus pneumoniae (MIC ≥4.0 μg/mL): 100 mg/kg/day every 12-24 hours 3
- For Group A Streptococcus: 50-100 mg/kg/day every 12-24 hours 2, 3
- For β-lactamase producing Haemophilus influenzae: 50-100 mg/kg/day every 12-24 hours 2, 3
Administration Guidelines
- Intravenous administration should be given over 30 minutes 1
- For intramuscular administration, inject well within a relatively large muscle 1
- Do not use diluents containing calcium (such as Ringer's solution or Hartmann's solution) to reconstitute ceftriaxone 1
Duration of Therapy
- Generally continue therapy for at least 2 days after signs and symptoms of infection have disappeared 1
- Usual duration: 4-14 days; longer therapy may be required for complicated infections 1
- For Streptococcus pyogenes infections, continue for at least 10 days 1
Clinical Considerations
- Once-daily administration has been shown to be effective for most serious bacterial infections in children with a 94% clinical cure rate 4
- For patients with high estimated glomerular filtration rate (>80 mL/min/1.73 m²) or in areas with less-susceptible pathogens, consider dividing the total daily dose into two administrations (e.g., 50 mg/kg twice daily) for better target attainment 5
- No dosage adjustment is necessary for patients with impairment of renal or hepatic function 1
Important Precautions
- Ceftriaxone is contraindicated in neonates (≤28 days) if they require calcium-containing IV solutions 1
- Do not mix ceftriaxone with vancomycin, amsacrine, aminoglycosides, or fluconazole in the same IV line 1
- When administering with other drugs, flush IV lines thoroughly between administrations 1
Recent pharmacokinetic studies confirm that the current standard dosing regimen provides adequate exposure for susceptible pathogens in most critically ill children 5, supporting the long-established safety and efficacy of once-daily administration for most infections 4.