Is it okay to take 1000mg of ceftriaxone (a broad-spectrum antibiotic) injection once a day for 2 days for congestion and sore throat?

Ceftriaxone Is Not Appropriate for Congestion and Sore Throat

Ceftriaxone injection 1000mg once daily for 2 days is not appropriate treatment for congestion and sore throat as these symptoms typically indicate a viral infection that does not require antibiotic therapy.

Why Ceftriaxone Is Not Indicated for These Symptoms

• Congestion and sore throat are most commonly caused by viral infections that do not respond to antibiotics 1, 2
• Ceftriaxone is a broad-spectrum antibiotic reserved for moderate to severe bacterial infections, not mild upper respiratory symptoms 1, 3
• Using antibiotics for viral infections contributes to antibiotic resistance without providing benefit 4
• The FDA-approved indications for ceftriaxone do not include uncomplicated upper respiratory infections 3

Appropriate Use of Ceftriaxone

• Ceftriaxone is indicated for serious bacterial infections including:

  • Bacterial meningitis (2g IV every 12 hours) 1
  • Complicated urinary tract infections (1-2g daily) 4, 1
  • Severe pneumonia and lower respiratory tract infections (1-2g daily) 5
  • Disseminated gonococcal infections (1g IM/IV daily) 1
  • Bacterial endocarditis (2g daily) 4, 1

• Standard adult dosing is 1-2g given once daily or divided twice daily depending on infection type and severity 1, 3

Risks of Inappropriate Ceftriaxone Use

• Adverse effects include:

  • Gastrointestinal disturbances (3.45% of patients) 6
  • Hypersensitivity reactions (2.99% of patients) 6
  • Local injection site reactions (1.86% of patients) 6
  • Risk of Clostridioides difficile infection 3

• Antimicrobial resistance development:

  • Unnecessary antibiotic use is the primary driver of resistance 4
  • Treatment failures have been reported with inappropriate ceftriaxone use 1

Appropriate Management for Congestion and Sore Throat

• For viral causes (most common):

  • Symptomatic treatment with rest, adequate hydration, and over-the-counter medications 4
  • Acetaminophen or NSAIDs for pain and fever 4
  • Saline nasal sprays or rinses for congestion 4

• When to consider antibiotics:

  • Confirmed bacterial infection (e.g., streptococcal pharyngitis) 4
  • Persistent symptoms beyond 10-14 days 4
  • Worsening symptoms after initial improvement 4

Important Considerations

• Ceftriaxone requires parenteral administration (IV or IM), which is unnecessarily invasive for mild symptoms 3
• If bacterial pharyngitis is suspected, throat culture or rapid strep test should be performed before starting antibiotics 4
• If antibiotics are truly needed for bacterial pharyngitis, oral options like amoxicillin or penicillin V would be first-line choices, not injectable ceftriaxone 4