Ceftriaxone Dosing for a 10-Month-Old Child Weighing 18 Pounds
For a 10-month-old child weighing 18 pounds (approximately 8.2 kg), the recommended dose of ceftriaxone is 50-75 mg/kg/day given once daily or divided every 12-24 hours, depending on the severity of infection. 1
General Dosing Guidelines
- For less severe infections, the dose should be 50-75 mg/kg/day given once daily or divided every 12-24 hours 1
- For severe infections including pneumonia, the dose should be 50-100 mg/kg/day given once daily or divided every 12-24 hours 1
- For bacterial meningitis, the dose should be 100 mg/kg/day divided every 12-24 hours (maximum 4 g daily) 1
- The total daily dose should not exceed 2 grams for most infections in pediatric patients 2
Specific Dosing Calculations for This Child
- For a child weighing 18 pounds (8.2 kg):
Administration Considerations
- Intravenous doses should be administered over 30 minutes in pediatric patients 2
- For intramuscular administration, inject well within the body of a relatively large muscle 2
- Do not use diluents containing calcium, such as Ringer's solution or Hartmann's solution, to reconstitute ceftriaxone 2
Clinical Efficacy
- Once-daily administration of ceftriaxone at 50 mg/kg has demonstrated a 93.7% overall effectiveness rate in pediatric patients with community-acquired pneumonia 3
- Studies have shown a 94% clinical cure rate with once-daily ceftriaxone (50-80 mg/kg) for serious bacterial infections in children 4
Special Considerations
- For patients with increased renal clearance (eGFR >80 mL/min/1.73 m²), a twice-daily dosing regimen of 50 mg/kg may improve target attainment, especially for less susceptible pathogens 5
- For specific infections like gonococcal conjunctivitis in children weighing ≤45 kg, the dose is 25-50 mg/kg body weight intravenous or IM, single dose, not to exceed 250 mg IM 6
Duration of Therapy
- Generally, ceftriaxone therapy should be continued for at least 2 days after signs and symptoms of infection have disappeared 2
- The usual duration of therapy is 4-14 days; in complicated infections, longer therapy may be required 2
- When treating infections caused by Streptococcus pyogenes, therapy should be continued for at least 10 days 2
Common Pitfalls and Caveats
- Ceftriaxone is contraindicated in hyperbilirubinemic neonates and premature infants 1, 2
- Ceftriaxone must not be administered simultaneously with calcium-containing IV solutions 2
- Monitor for potential adverse effects, although studies show they are generally mild and don't typically require discontinuation of therapy 4