Table of ContentsView AllTable of ContentsUsesBefore TakingDosageSide EffectsWarnings and Interactions
Table of ContentsView All
View All
Table of Contents
Uses
Before Taking
Dosage
Side Effects
Warnings and Interactions
Ceftriaxone is a type ofantibiotic drugused to treatbacterial infections. It belongs to a class of drugs calledcephalosporin antibiotics. These third-generation cephalosporins are used to treat bacterial strains that are commonly resistant to other types of antibiotics.
Cravetiger / Getty Images
Every Antibiotics Question You Have, Answered
These are the bacterial types that tend to be resistant to earlier-generation antibiotics.
What Is Antibiotic Resistance?
Antibiotic resistance can develop if an antibiotic is overused. If a bacteria becomes resistant to an antibiotic, that antibiotic (and often others like it) will be less able to cure an infection. Although there may be second- and third-line treatments available, those medications can cause serious side effects, such as organ failure and prolong care and recovery. In some cases, there may be no treatment options.
There are some bacteria types that ceftriaxone cannot treat. These includeEnterobacterspecies,Listeria monocytogenes, Pseudomonas aeruginosa, andMethicillin-resistantStaphylococcus aureus(MRSA). For these infections, fourth-generation cephalosporin antibiotics like cefepime may be used.
Why You Don’t Need Antibiotics for Colds or Flu
Types of Infections Treated
Although ceftriaxone and other third-generation cephalosporins are effective in treating a wide variety of bacterial infections, they tend to be reserved for harder-to-treat cases. Doing so prevents the overuse of the drug and can slow the development of ceftriaxone resistance.
Among the infections for which ceftriaxone is commonly used:
Ceftriaxone is also sometimes used before surgery to reduce the risk of postoperative infection. This is referred to as preoperative prophylaxis.
Off-Label Uses
While ceftriaxone, like other antibiotics, cannot treat viral, fungal, or parasitic infections, early studies suggest it may have other therapeutic benefits. However, more data is needed to confirm its efficacy. These include:
Early studies suggest ceftriaxone might have neuroprotective properties that may aid in the treatment of neurodegenerative disorders likeAlzheimer’s disease,Parkinson’s disease,Huntington’s disease, andamyotrophic lateral sclerosis (ALS).Other studies are exploring whether ceftriaxone can aid in the treatment of alcohol and opioid addiction or help relievechronic pain.
It is unclear if ceftriaxone can aid in the treatment of any of these conditions. Until further evidence can be found, ceftriaxone should only be used as indicated under the direction of a healthcare provider.
Before prescribing ceftriaxone, the practitioner will perform tests to identify which bacterium is causing the infection. These may involve a blood or urine test (such as those used to diagnosegonorrhea) or abacteria culture(including those used to diagnosestrep throat).
Other more severe infections, like sepsis or bacterial meningitis, may require antimicrobial susceptibility testing (AST) to determinehowresistant a bacteria is to available antibiotic drugs.
There are different methods a lab can use, including blood, urine, sputum, stool, and spinal fluid tests that help identify the genotype (genetic makeup) of the bacterium and culture-based tests that identify the phenotype (physical makeup) of the bacterium.
These insights can help thepathologistpredict with a high level of accuracy whether the bacterium is susceptible to ceftriaxone or if different antibiotics are better suited for treatment.
Precautions and Contraindications
The only absolute contraindication for ceftriaxone use is a known allergy to the antibiotic itself and any inactive ingredient in the formulation.
Having an allergy to other third-generation cephalosporins does not mean that you will be allergic to ceftriaxone. Nevertheless, ceftriaxone should be used with caution if you are. These include cephalosporin antibiotics like:
There is a risk of cross-reactive allergy to ceftriaxone if you are allergic topenicillin. If you’ve had a severe allergic reaction to penicillin in the past, you should never use ceftriaxone.
Are Cephalosporins Safe if You’re Allergic to Penicillin?
Ceftriaxone should not be used in newborns withhyperbilirubinemia(highbilirubin). Doing so can cause bilirubin encephalitis, an inflammatory brain condition that can lead to hearing loss, brain damage, or death.
Ceftriaxone should never be used with intravenous calcium preparations (includingRinger’s solution) in newborns younger than 28 days.Doing so can cause potentially fatal injury to the lungs and kidneys.
Ceftriaxone is generally considered safe for use during pregnancy.Even so, speak with your healthcare provider to understand the benefits and risks of treatment if you are pregnant, planning to get pregnant, or breastfeeding.
Ceftriaxone comes either as a sterile powder that is reconstituted with a liquid or a frozen premixed solution that is thawed before use. The drug can then be injected into a large muscle or delivered intravenously into a vein. Of the two formulations:
Adults
If your healthcare provider feels it is needed, ceftriaxone is used to treat both complicated and uncomplicated bacterial infections in adults. The recommended ceftriaxone dose for adults is between 250 mg and 2 grams per day, delivered as either a single dose or two equally divided doses given 12 hours apart. If needed, up to 4 grams can be used daily.
If you are on ceftriaxone, speak to your prescribing healthcare provider about the appropriate duration of treatment. As a general rule, ceftriaxone should be continued for at least two days after the symptoms of the infection have cleared. This usually takes between four and 14 days. Complicated infections may take longer.
Children
Ceftriaxone is generally indicated for the treatment of severe bacterial infections in babies, toddlers, and younger children.
Teenagers with certain bacterial infections, such as gonorrhea orsyphilis, may be treated in the same way as adults.
Serious Antibiotic Side Effects in Children
Modifications
How to Take and Store
Intramuscular injections can be delivered into the buttocks, thigh, or other large muscles. Intravenous injections can either be injected directly into a vein or be infused through an intravenous (IV) line over 30 minutes or more.
Antibiotics for Upper Respiratory Infections
Like all drugs, ceftriaxone may cause side effects. The common side effects of ceftriaxone are similar to those of other injected or intravenous antibiotics.
Common
Ceftriaxone will not cause symptoms in everyone but is more likely to do so at higher doses. The side effects affecting at least 1% of users include:
Less common side effects include headaches, dizziness, itching, fever, nausea, vomiting, vaginal inflammation (vaginitis), and thrush (candidiasis). Children can sometimes develop gallstones due to an overproduction of bile. Neurological adverse reactions includeencephalopathyand seizures.
Severe
If not treated as a medical emergency, SJS and TEN can cause massivedehydration,sepsis,shock,pneumonia, multiple organ failure, and death.
When to Call 911
Cephalosporin antibiotics and penicillin are two of the more common drugs causes of SJS and TEN.
Severe cases ofhemolytic anemiahave been reported in people on ceftriaxone therapy. This is a form ofanemiain which red blood cells are destroyed faster than they can be made. Treatment should be stopped immediately for anyone who develops anemia while on ceftriaxone and discontinued until the underlying cause is identified.
Clostridioides difficile-associated diarrheahas been reported with almost every antibacterial agent, caused when the drug alters the natural flora of the gut and allowsC. difficileto proliferate. This condition can affect anyone, though you may be at higher risk if you are 65 and older, had a recent stay at a nursing home or hospital, have a weakened immune system, or were recently infected withC. difficileor had a known exposure.If diarrhea develops during ceftriaxone therapy, treatment should be stopped.
If needed, antibiotics like Flagyl (metronidazole), Dificid (fidaxomicin), and Vancomycin (oral vancomycin) can be used to resolve theC. difficileinfection.On rare occasions,C. difficile-associated diarrhea can lead to pseudomembranous colitis, the potentially fatal inflammation of the large intestine.
Antibiotics Most Likely to Cause Diarrhea
Drug Interactions
Due to the risk of calcium–ceftriaxone precipitation in the gallbladder, ceftriaxone should not be used with any the following calcium-containing solutions in persons of any age (and avoided without exception in newborns):
There are instances when these calcium-containing solutions may be necessary, such as during pregnancy or surgery. If so, the dose of ceftriaxone can be separated from that of the calcium-containing product to minimize the risk.
Other drugs that can interact with ceftriaxone include:
To avoid interactions, always let your healthcare provider know about any drug you are taking, whether it is prescription, over-the-counter, herbal, or recreational.
A Word From Verywell
Ceftriaxone is an important and effective antibiotic, but one that has its limitations. It used inappropriately, it can cause more harm than good.
To reduce your risk of harm, let your healthcare provider know about any allergic reaction you have had to an antibiotic, and be sure that it is notated yourelectronic medical records (EMR). If you’ve ever had a severe reaction to ceftriaxone, penicillin, or any antibiotic drug, including SJS, TEN, oranaphylaxis, consider getting amedical ID braceletso that medical staff are aware of this in the event of an emergency.
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fair RJ, Tor Y.Antibiotics and bacterial resistance in the 21st century.Perspect Medicin Chem. 2014;6:25-64. doi:10.4137/PMC.S14459Fisher J, Ganellin CR, IUPAC.Analogue-based Drug Discovery (1st Edition). Hoboken, New Jersey: Wiley VCH Books.Kapoor G, Saigal S, Elongavan A.Action and resistance mechanisms of antibiotics: A guide for clinicians.J Anaesthesiol Clin Pharmacol.2017;33(3):300-5. doi:10.4103/joacp.JOACP_349_15Lupin Pharmaceuticals.Ceftriaxone injection, powder, for solution.Centers for Disease Control and Prevention.About antimicrobial resistance.World Health Organization.Antibiotic resistance.National Center for Biotechnology Information.Cefepime.Dimovska-Gavrilovska A, Chaparoski A, Gavrilovski A, Milenkovikj Z.The importance of perioperative prophylaxis with cefuroxime or ceftriaxone in the surgical site infections prevention after cranial and spinal neurosurgical procedures.Pril (Makedon Akad Nauk Umet Odd Med Nauki).2017;38(2):85-97. doi:10.1515/prilozi-2017-0026Carvalho HT de, Fioretto JR, Ribeiro CF, Laraia IO, Carpi MF.Diagnosis and treatment of streptococcal toxic shock syndrome in the pediatric intensive care unit: case report.Revista Brasileira de Terapia Intensiva. 2019;31(4). doi:10.5935/0103-507X.20190068Guarino M, Perna B, Cesaro AE, et al.2023 update on sepsis and septic shock in adult patients: management in the emergency department.JCM. 2023;12(9):3188. doi:10.3390/jcm12093188Yimer EM, Hishe HZ, Tuem KB.Repurposing of the β-lactam antibiotic, ceftriaxone for neurological disorders: A review.Front Neurosci. 2019;13:236. doi:10.3389/fnins.2019.00236Khan ZA, Siddiqui MF, Park S.Current and emerging methods of antibiotic susceptibility testing.Diagnostics (Basel). 2019;9(2):49. doi:10.3390/diagnostics9020049Trubiano JA, Stone CA, Grayson ML, et al.The 3 Cs of antibiotic allergy-classification, cross-reactivity, and collaboration.J Allergy Clin Immunol Pract.2017;5(6):1532-42. doi:10.1016/j.jaip.2017.06.017Karimzadeh P, Fallahi M, Kazemian M, Taslimi Taleghani N, Nouripour S, Radfar M.Bilirubin induced encephalopathy.Iran J Child Neurol.B Braun Medical. Ceftriaxone for injection and dextrose injection.Fakoya AOJ, Omenyi P, Anthony P, et al.Stevens-Johnson syndrome and toxic epidermal necrolysis; Extensive review of reports of drug-induced etiologies, and possible therapeutic modalities.Open Access Maced J Med Sci.2018;6(4):730-8. doi:10.3889/oamjms.2018.148Blumenthal KG, Peter JG, Trubiano JA, Phillips EJ.Antibiotic allergy.Lancet. 2019;393(10167):183-98. doi:10.1016/S0140-6736(18)32218-9Leicht HB, Weinig E, Mayer B, Viebahn J, Geier A, Rau M.Ceftriaxone-induced hemolytic anemia with severe renal failure: a case report and review of literature.BMC Pharmacol Toxicol.2018;19(1):67. doi:10.1186/s40360-018-0257-7Centers for Disease Control and Prevention.What is C. diff?Al-Jashaami LS, Dupont HL.Management of Clostridium difficile infection.Gastroenterol Hepatol (N Y).
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fair RJ, Tor Y.Antibiotics and bacterial resistance in the 21st century.Perspect Medicin Chem. 2014;6:25-64. doi:10.4137/PMC.S14459Fisher J, Ganellin CR, IUPAC.Analogue-based Drug Discovery (1st Edition). Hoboken, New Jersey: Wiley VCH Books.Kapoor G, Saigal S, Elongavan A.Action and resistance mechanisms of antibiotics: A guide for clinicians.J Anaesthesiol Clin Pharmacol.2017;33(3):300-5. doi:10.4103/joacp.JOACP_349_15Lupin Pharmaceuticals.Ceftriaxone injection, powder, for solution.Centers for Disease Control and Prevention.About antimicrobial resistance.World Health Organization.Antibiotic resistance.National Center for Biotechnology Information.Cefepime.Dimovska-Gavrilovska A, Chaparoski A, Gavrilovski A, Milenkovikj Z.The importance of perioperative prophylaxis with cefuroxime or ceftriaxone in the surgical site infections prevention after cranial and spinal neurosurgical procedures.Pril (Makedon Akad Nauk Umet Odd Med Nauki).2017;38(2):85-97. doi:10.1515/prilozi-2017-0026Carvalho HT de, Fioretto JR, Ribeiro CF, Laraia IO, Carpi MF.Diagnosis and treatment of streptococcal toxic shock syndrome in the pediatric intensive care unit: case report.Revista Brasileira de Terapia Intensiva. 2019;31(4). doi:10.5935/0103-507X.20190068Guarino M, Perna B, Cesaro AE, et al.2023 update on sepsis and septic shock in adult patients: management in the emergency department.JCM. 2023;12(9):3188. doi:10.3390/jcm12093188Yimer EM, Hishe HZ, Tuem KB.Repurposing of the β-lactam antibiotic, ceftriaxone for neurological disorders: A review.Front Neurosci. 2019;13:236. doi:10.3389/fnins.2019.00236Khan ZA, Siddiqui MF, Park S.Current and emerging methods of antibiotic susceptibility testing.Diagnostics (Basel). 2019;9(2):49. doi:10.3390/diagnostics9020049Trubiano JA, Stone CA, Grayson ML, et al.The 3 Cs of antibiotic allergy-classification, cross-reactivity, and collaboration.J Allergy Clin Immunol Pract.2017;5(6):1532-42. doi:10.1016/j.jaip.2017.06.017Karimzadeh P, Fallahi M, Kazemian M, Taslimi Taleghani N, Nouripour S, Radfar M.Bilirubin induced encephalopathy.Iran J Child Neurol.B Braun Medical. Ceftriaxone for injection and dextrose injection.Fakoya AOJ, Omenyi P, Anthony P, et al.Stevens-Johnson syndrome and toxic epidermal necrolysis; Extensive review of reports of drug-induced etiologies, and possible therapeutic modalities.Open Access Maced J Med Sci.2018;6(4):730-8. doi:10.3889/oamjms.2018.148Blumenthal KG, Peter JG, Trubiano JA, Phillips EJ.Antibiotic allergy.Lancet. 2019;393(10167):183-98. doi:10.1016/S0140-6736(18)32218-9Leicht HB, Weinig E, Mayer B, Viebahn J, Geier A, Rau M.Ceftriaxone-induced hemolytic anemia with severe renal failure: a case report and review of literature.BMC Pharmacol Toxicol.2018;19(1):67. doi:10.1186/s40360-018-0257-7Centers for Disease Control and Prevention.What is C. diff?Al-Jashaami LS, Dupont HL.Management of Clostridium difficile infection.Gastroenterol Hepatol (N Y).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Fair RJ, Tor Y.Antibiotics and bacterial resistance in the 21st century.Perspect Medicin Chem. 2014;6:25-64. doi:10.4137/PMC.S14459Fisher J, Ganellin CR, IUPAC.Analogue-based Drug Discovery (1st Edition). Hoboken, New Jersey: Wiley VCH Books.Kapoor G, Saigal S, Elongavan A.Action and resistance mechanisms of antibiotics: A guide for clinicians.J Anaesthesiol Clin Pharmacol.2017;33(3):300-5. doi:10.4103/joacp.JOACP_349_15Lupin Pharmaceuticals.Ceftriaxone injection, powder, for solution.Centers for Disease Control and Prevention.About antimicrobial resistance.World Health Organization.Antibiotic resistance.National Center for Biotechnology Information.Cefepime.Dimovska-Gavrilovska A, Chaparoski A, Gavrilovski A, Milenkovikj Z.The importance of perioperative prophylaxis with cefuroxime or ceftriaxone in the surgical site infections prevention after cranial and spinal neurosurgical procedures.Pril (Makedon Akad Nauk Umet Odd Med Nauki).2017;38(2):85-97. doi:10.1515/prilozi-2017-0026Carvalho HT de, Fioretto JR, Ribeiro CF, Laraia IO, Carpi MF.Diagnosis and treatment of streptococcal toxic shock syndrome in the pediatric intensive care unit: case report.Revista Brasileira de Terapia Intensiva. 2019;31(4). doi:10.5935/0103-507X.20190068Guarino M, Perna B, Cesaro AE, et al.2023 update on sepsis and septic shock in adult patients: management in the emergency department.JCM. 2023;12(9):3188. doi:10.3390/jcm12093188Yimer EM, Hishe HZ, Tuem KB.Repurposing of the β-lactam antibiotic, ceftriaxone for neurological disorders: A review.Front Neurosci. 2019;13:236. doi:10.3389/fnins.2019.00236Khan ZA, Siddiqui MF, Park S.Current and emerging methods of antibiotic susceptibility testing.Diagnostics (Basel). 2019;9(2):49. doi:10.3390/diagnostics9020049Trubiano JA, Stone CA, Grayson ML, et al.The 3 Cs of antibiotic allergy-classification, cross-reactivity, and collaboration.J Allergy Clin Immunol Pract.2017;5(6):1532-42. doi:10.1016/j.jaip.2017.06.017Karimzadeh P, Fallahi M, Kazemian M, Taslimi Taleghani N, Nouripour S, Radfar M.Bilirubin induced encephalopathy.Iran J Child Neurol.B Braun Medical. Ceftriaxone for injection and dextrose injection.Fakoya AOJ, Omenyi P, Anthony P, et al.Stevens-Johnson syndrome and toxic epidermal necrolysis; Extensive review of reports of drug-induced etiologies, and possible therapeutic modalities.Open Access Maced J Med Sci.2018;6(4):730-8. doi:10.3889/oamjms.2018.148Blumenthal KG, Peter JG, Trubiano JA, Phillips EJ.Antibiotic allergy.Lancet. 2019;393(10167):183-98. doi:10.1016/S0140-6736(18)32218-9Leicht HB, Weinig E, Mayer B, Viebahn J, Geier A, Rau M.Ceftriaxone-induced hemolytic anemia with severe renal failure: a case report and review of literature.BMC Pharmacol Toxicol.2018;19(1):67. doi:10.1186/s40360-018-0257-7Centers for Disease Control and Prevention.What is C. diff?Al-Jashaami LS, Dupont HL.Management of Clostridium difficile infection.Gastroenterol Hepatol (N Y).
Fair RJ, Tor Y.Antibiotics and bacterial resistance in the 21st century.Perspect Medicin Chem. 2014;6:25-64. doi:10.4137/PMC.S14459
Fisher J, Ganellin CR, IUPAC.Analogue-based Drug Discovery (1st Edition). Hoboken, New Jersey: Wiley VCH Books.
Kapoor G, Saigal S, Elongavan A.Action and resistance mechanisms of antibiotics: A guide for clinicians.J Anaesthesiol Clin Pharmacol.2017;33(3):300-5. doi:10.4103/joacp.JOACP_349_15
Lupin Pharmaceuticals.Ceftriaxone injection, powder, for solution.
Centers for Disease Control and Prevention.About antimicrobial resistance.
World Health Organization.Antibiotic resistance.
National Center for Biotechnology Information.Cefepime.
Dimovska-Gavrilovska A, Chaparoski A, Gavrilovski A, Milenkovikj Z.The importance of perioperative prophylaxis with cefuroxime or ceftriaxone in the surgical site infections prevention after cranial and spinal neurosurgical procedures.Pril (Makedon Akad Nauk Umet Odd Med Nauki).2017;38(2):85-97. doi:10.1515/prilozi-2017-0026
Carvalho HT de, Fioretto JR, Ribeiro CF, Laraia IO, Carpi MF.Diagnosis and treatment of streptococcal toxic shock syndrome in the pediatric intensive care unit: case report.Revista Brasileira de Terapia Intensiva. 2019;31(4). doi:10.5935/0103-507X.20190068
Guarino M, Perna B, Cesaro AE, et al.2023 update on sepsis and septic shock in adult patients: management in the emergency department.JCM. 2023;12(9):3188. doi:10.3390/jcm12093188
Yimer EM, Hishe HZ, Tuem KB.Repurposing of the β-lactam antibiotic, ceftriaxone for neurological disorders: A review.Front Neurosci. 2019;13:236. doi:10.3389/fnins.2019.00236
Khan ZA, Siddiqui MF, Park S.Current and emerging methods of antibiotic susceptibility testing.Diagnostics (Basel). 2019;9(2):49. doi:10.3390/diagnostics9020049
Trubiano JA, Stone CA, Grayson ML, et al.The 3 Cs of antibiotic allergy-classification, cross-reactivity, and collaboration.J Allergy Clin Immunol Pract.2017;5(6):1532-42. doi:10.1016/j.jaip.2017.06.017
Karimzadeh P, Fallahi M, Kazemian M, Taslimi Taleghani N, Nouripour S, Radfar M.Bilirubin induced encephalopathy.Iran J Child Neurol.
B Braun Medical. Ceftriaxone for injection and dextrose injection.
Fakoya AOJ, Omenyi P, Anthony P, et al.Stevens-Johnson syndrome and toxic epidermal necrolysis; Extensive review of reports of drug-induced etiologies, and possible therapeutic modalities.Open Access Maced J Med Sci.2018;6(4):730-8. doi:10.3889/oamjms.2018.148
Blumenthal KG, Peter JG, Trubiano JA, Phillips EJ.Antibiotic allergy.Lancet. 2019;393(10167):183-98. doi:10.1016/S0140-6736(18)32218-9
Leicht HB, Weinig E, Mayer B, Viebahn J, Geier A, Rau M.Ceftriaxone-induced hemolytic anemia with severe renal failure: a case report and review of literature.BMC Pharmacol Toxicol.2018;19(1):67. doi:10.1186/s40360-018-0257-7
Centers for Disease Control and Prevention.What is C. diff?
Al-Jashaami LS, Dupont HL.Management of Clostridium difficile infection.Gastroenterol Hepatol (N Y).
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
