Recommended Dosing of Rocephin (Ceftriaxone) for Injection
The usual adult daily dose of Rocephin (ceftriaxone) for injection is 1 to 2 grams given once daily (or in equally divided doses twice daily) depending on the type and severity of infection, with a maximum daily dose of 4 grams. 1, 2
Standard Adult Dosing Guidelines
- For most adult infections, ceftriaxone should be dosed at 1-2 grams intravenously or intramuscularly every 24 hours, with specific dosing based on infection type and severity 3
- For uncomplicated gonococcal infections, a single intramuscular dose of 250 mg is recommended 1, 2
- For preoperative use (surgical prophylaxis), a single dose of 1 gram administered intravenously 1/2 to 2 hours before surgery is recommended 1, 2
- Generally, ceftriaxone therapy should be continued for at least 2 days after signs and symptoms of infection have disappeared, with usual duration of 4-14 days; complicated infections may require longer therapy 1, 2
Dosing for Specific Infections
Gonococcal Infections
- For gonococcal conjunctivitis: Ceftriaxone 1 gram IM in a single dose 4
- For disseminated gonococcal infection (DGI): Ceftriaxone 1 gram IM or IV every 24 hours, continued for 24-48 hours after improvement begins 4, 3
- For gonococcal meningitis and endocarditis: Ceftriaxone 1-2 grams IV every 12 hours (for 10-14 days for meningitis and at least 4 weeks for endocarditis) 3
Meningitis
- For bacterial meningitis: Ceftriaxone 2 grams IV every 12 hours (total 4 grams daily) 3
- For pneumococcal meningitis: Ceftriaxone 2 grams IV every 12 hours for 10-14 days 3
- For meningococcal meningitis: Ceftriaxone 2 grams IV every 12 hours for 5 days 3
Pediatric Dosing
- For skin and skin structure infections: 50-75 mg/kg once daily (or in equally divided doses twice daily), not to exceed 2 grams total daily dose 1, 2
- For acute bacterial otitis media: Single intramuscular dose of 50 mg/kg (not to exceed 1 gram) 1, 2
- For serious infections other than meningitis: 50-75 mg/kg daily in divided doses every 12 hours, not to exceed 2 grams total daily dose 1, 2
- For meningitis: Initial dose of 100 mg/kg (not to exceed 4 grams), followed by 100 mg/kg/day (not to exceed 4 grams daily) for 7-14 days 1, 2
- For children who weigh <45 kg with uncomplicated gonococcal infections: Ceftriaxone 125 mg IM in a single dose 4
- For children who weigh <45 kg with bacteremia or arthritis: Ceftriaxone 50 mg/kg (maximum 1 gram) IM or IV daily for 7 days 4
Administration Guidelines
- Intravenous administration should be over a period of 30 minutes 1, 2
- For neonates, administer over 60 minutes to reduce the risk of bilirubin encephalopathy 1, 2
- For intramuscular injection, reconstitute with appropriate diluent and inject well within the body of a relatively large muscle 1, 2
- Do not use diluents containing calcium, such as Ringer's solution or Hartmann's solution 1, 2
Special Considerations
- No dosage adjustment is necessary for patients with impairment of renal or hepatic function 1, 2
- The dosages recommended for adults require no modification in elderly patients up to 2 grams per day, provided there is no severe renal and hepatic impairment 1, 2
- Ceftriaxone exhibits an exceptionally long elimination half-life (5.8 to 8.7 hours) compared to other cephalosporins 5
- After intramuscular administration, ceftriaxone is rapidly and completely absorbed 5, 6
- Plasma concentrations exceed the minimal inhibitory concentrations (MICs) of most aerobic gram-positive and gram-negative organisms for 24 hours after a 1-gram dose 6