From the Guidelines
Community-Acquired Pneumonia Treatment with Ceftriaxone
The recommended dose of Ceftriaxone for community-acquired pneumonia is 1-2 grams administered intravenously every 24 hours 1.
- The duration of therapy typically ranges from 5 to 7 days, depending on the severity of the infection and the patient's clinical response.
- In cases of severe community-acquired pneumonia, a dose of 2 grams every 12 hours may be considered, with the treatment course lasting 7 to 10 days. Key considerations for the treatment of community-acquired pneumonia include the severity of illness, pathogen probabilities, resistance patterns of S. pneumoniae, and comorbid conditions 1.
- For outpatients, administration of a macrolide, doxycycline, or fluoroquinolone with enhanced activity against S. pneumoniae is recommended 1.
- For patients who are hospitalized, the recommendation is administration of a fluoroquinolone alone or an extended-spectrum cephalosporin (such as ceftriaxone) plus a macrolide 1.
- Patients hospitalized in the intensive care unit (ICU) should receive ceftriaxone, cefotaxime, ampicillin-sulbactam, or piperacillin-tazobactam in combination with a fluoroquinolone or macrolide 1. The choice of antibiotic and duration of therapy should be guided by clinical response and microbiological results, when available 1.
From the Research
Dose of Ceftriaxone for Community-Acquired Pneumonia
- The recommended dose of ceftriaxone for community-acquired pneumonia is 1-2 g daily, as stated in various studies 2, 3, 4.
- A systematic review and meta-analysis found that ceftriaxone dosages of 1 g daily are as safe and effective as other antibiotic regimens for community-acquired pneumonia 2.
- A retrospective cohort study found that 1 g/d of IV ceftriaxone is associated with similar clinical outcomes to those of 2 g/d, with a decreased rate of C. difficile infection and shorter length of stay 3.
- Guidelines recommend intravenous (IV) ceftriaxone at a dose of 1-2 g/d as empirical treatment in adults hospitalized with community-acquired pneumonia (CAP), with the addition of macrolide 4.
Specific Patient Groups
- For patients admitted to general wards with criteria of moderate severity, ceftriaxone 1-2 g once a day or cefotaxime 1 g TID, IV, 7-10 days is recommended 4.
- For patients with severe CAP that must be interned into ICU, ceftriaxone 2 g once a day or cefotaxime 1 g TID, IV, associated to erythromycin 500 QID, levofloxacin 500-1.000 mg once a day, or moxifloxacin 400 mg/once a day, IV, 10-14 days is recommended 4.
Treatment Duration
- The treatment duration for community-acquired pneumonia is still under debate, but several studies support short durations of 5-7 days or less 5.
- Clinical criteria could be possibly used to discontinue antibiotic treatment, and procalcitonin has also been studied as a potential biomarker to guide treatment duration 5.