From the Guidelines
Ceftriaxone is a recommended antibiotic for the treatment of pneumonia, particularly for patients with community-acquired pneumonia (CAP) who require hospitalization.
Typical Dosage and Treatment Duration
The typical dose of ceftriaxone for pneumonia is 1-2 grams administered intravenously every 12-24 hours, with a treatment duration of 5-7 days for mild to moderate cases and 7-10 days for more severe cases 1.
Combination Therapy
In combination with a macrolide, such as azithromycin, ceftriaxone may be used to treat patients with CAP who have underlying comorbidities or require intensive care unit (ICU) admission 1.
Key Points
- Ceftriaxone is effective against a wide range of bacterial pathogens, including Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus 1.
- The choice of antibiotic therapy should be based on the severity of illness, pathogen probabilities, resistance patterns, and comorbid conditions 1.
- Ceftriaxone is a recommended option for patients with CAP who require hospitalization, particularly those with severe disease or underlying comorbidities 1.
From the FDA Drug Label
Ceftriaxone for Injection is indicated for the treatment of the following infections when caused by susceptible organisms: LOWER RESPIRATORY TRACT INFECTIONS Caused by Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Escherichia coli, Enterobacter aerogenes, Proteus mirabilis or Serratia marcescens
The role of Ceftriaxone in pneumonia is to treat lower respiratory tract infections caused by susceptible organisms, including:
- Streptococcus pneumoniae
- Staphylococcus aureus
- Haemophilus influenzae
- Haemophilus parainfluenzae
- Klebsiella pneumoniae
- Escherichia coli
- Enterobacter aerogenes
- Proteus mirabilis
- Serratia marcescens 2
From the Research
Role of Ceftriaxone in Pneumonia
- Ceftriaxone is recommended as first-line antibiotic treatment for hospitalized adults with community-acquired pneumonia (CAP), often in combination with a macrolide 3, 4.
- The efficacy of ceftriaxone in treating CAP has been compared to other antibiotics, such as ampicillin and levofloxacin, with similar clinical outcomes 3, 4.
- The optimal dosage of ceftriaxone for CAP treatment has been studied, with 1g daily being as effective as higher dosages, such as 2g daily 5, 6.
- However, ceftriaxone may not be sufficient for treating CAP caused by methicillin-susceptible Staphylococcus aureus (MSSA), with higher rates of early clinical failure and longer hospital stays 7.
Clinical Outcomes
- Studies have shown that ceftriaxone is associated with similar clinical outcomes to other antibiotics, such as ampicillin and levofloxacin, in treating CAP 3, 4.
- The 30-day all-cause mortality rate was similar between patients treated with ceftriaxone and those treated with other antibiotics 3, 5.
- Ceftriaxone has been associated with a lower rate of Clostridioides difficile infection (CDI) compared to other antibiotics 3, 5.
Dosage and Efficacy
- The efficacy of ceftriaxone 1g daily has been compared to higher dosages, such as 2g daily, with similar clinical outcomes 5, 6.
- A systematic review and meta-analysis found that ceftriaxone 1g daily is as safe and effective as other antibiotic regimens for CAP 6.
- However, the optimal dosage of ceftriaxone for CAP treatment may depend on the specific causative pathogen, such as MSSA 7.