Ceftriaxone for children: instructions for use

Ceftriaxone is one of the popular cephalosporin antibiotics, which belongs to the third generation of such drugs. Since when it enters the digestive tract, it is rapidly destroyed, the only dosage form of such a drug is injectable. In syrup, tablets, capsules and other forms of the drug with this name is not. Injections of "Ceftriaxone" are often prescribed to adults with sinusitis, otitis media, peritonitis, pneumonia and other infectious diseases. The medication is also in demand in childhood.

Release form

Ceftriaxone is produced by many Russian pharmaceutical companies (Kraspharma, Biosintez, Deco, Lecco, Sintez, etc.) and abroad - in India, China, Kazakhstan, Belarus and other countries. The name of the drug sometimes has a prefix in the form of an additional word or abbreviation. She points to the manufacturer, for example, Ceftriaxon Kabi is a product of the German company Fresenius Kabi, Ceftriaxon-LEKSVM is produced by the domestic manufacturer Protek-SVM, and Ceftriaxon-Jodas is manufactured in India by Jodas Expoim. However, all these drugs are comparable to the usual "Ceftriaxone", because they have the same active substance and the same form of release.

The medication is a crystalline powder, which is usually white in color, but there may be a slight yellowness or a faint orange tint. It is sold in glass bottles with a capacity of 10 or 20 ml, tightly closed with a rubber stopper and a metal cap (sometimes also with a plastic stopper).

There can be only one bottle in one box, but packages containing 5-10 or more bottles are also sold. Sometimes a solvent is attached to them, which is ampoules with 5 ml of clear liquid.

Composition

The main and only component of the powder is the substance of the same name, which is contained in the medicine in the form of sodium salt. Its dosage in one bottle can be:

250 mg;
500 mg;
1000 mg (1 g);
2000 mg (2 g).

In addition to this compound, there are no other substances inside the bottle. If the package contains a solvent, then it is represented by sterile water.

Operating principle

The drug has a broad spectrum bactericidal effect. It affects harmful microorganisms, disrupting the synthesis of their cell walls. This effect leads to the death of the pathogen and a decrease in the inflammatory response. The drug is capable of destroying:

Staphylococcus aureus;
pyogenic streptococci;
other types of streptococci;
citrobacters;
enterobacteria;
Klebsiella (including the causative agent of pneumonia);
colibacilli;
morganella;
pseudomonas;
meningococci;
proteas;
salmonella;
gonococci;
providence;
shigella;
cholera vibrios;
clostridia;
fusobacteria;
peptococci;
Yersinia and some other pathogens.

However, many strains of enterococci, some staphylococci, enterobacteria, pseudomonads, bacteroids are resistant to the drug. Injections also do not work on viruses, pathogenic fungi and protozoa, therefore they are not prescribed for mononucleosis, ARVI, fungal infection, and so on.

Indications

The reason for prescribing Ceftriaxone to a child is:

otitis media caused by pathogenic bacteria;
angina;
bacterial meningitis;
sinusitis;
bronchitis;
pneumonia;
cholangitis;
peritonitis;
an infection of the subcutaneous tissue or skin;
bone infection;
pyelonephritis;
infection of the genitourinary organs;
suppuration of skin wounds or burns;
lung abscess;
endocarditis;
Lyme disease;
other infections caused by bacteria that are sensitive to the medication.

Injections can also be used to prevent postoperative infection, for example, if a child is about to undergo heart or kidney surgery. Sometimes ENT doctors prescribe inhalations in a nebulizer, as well as complex drops, which include Ceftriaxone.

Such treatment is used for purulent rhinitis, adenoiditis or sinusitis, however, most experts do not advise dripping such an antibiotic into the nose, since there are special means for this purpose.

At what age is it allowed?

Treatment with "Ceftriaxone" is possible at any age, therefore, such an antibiotic is prescribed from birth, including infants who were born prematurely.

Contraindications

Ceftriaxone is prohibited to use only in patients with hypersensitivity to its active compound, as well as in case of allergy to other cephalosporins. However, there are quite a few conditions that require caution when prescribing such injections:

if the baby was born prematurely;
if the patient has hypersensitivity to drugs from the carbapenem or penicillin group;
if the child has liver failure;
if the medication is prescribed to a newborn with hyperbilirubinemia;
if the kidneys of a small patient are impaired;
if, after treatment with antibiotics, the child has developed enteritis or colitis (including in the past).

Side effects

Ceftriaxone can provoke an allergic reaction, such as a skin rash, erythema, edema, chills, itching, fever, or other symptom of an allergy. In such a situation, the medication is immediately canceled and a doctor is consulted.

The drug often causes a local reaction. With intramuscular injections, it is often pain and seals, when injected into a vein - painful sensations or phlebitis. In addition, children may complain of dizziness or headaches during treatment with Ceftriaxone.

The digestive tract of children receiving Ceftriaxone may react to the medication with nausea, abdominal pain, inflammation of the tongue, flatulence, taste changes, and other disorders. Sometimes, as a result of treatment with such a remedy, enterocolitis (it is called pseudomembranous), pancreatitis or bile stagnation develops. With such symptoms, the use of the drug is discontinued.

A medication can cause candidiasis or superinfection, when the body's resistance under the influence of injections decreases and it becomes more susceptible to various pathogens. Because of this, thrush or other infection may occur after ingestion.

Occasionally, the use of "Ceftriaxone" affects the blood picture, provoking leukopenia (due to neutropenia and lymphopenia), thrombocytopenia and a decrease in the number of erythrocytes. In some children, a blood test, on the contrary, shows thrombocytosis and leukocytosis. The consequence of such a negative effect on the organs of hematopoiesis is bleeding and anemia. In order to prevent their appearance, when prescribing a medicine for a course longer than 10 days, control blood tests are required.

With prolonged therapy, the antibiotic can change other indicators, for example, the prothrombin time (it can both increase and shorten), the level of bilirubin (increases), the activity of liver enzymes (increases), the concentration of urea (increases). Erythrocytes and glucose can be detected in the patient's urine.

Instructions for use

Ceftriaxone can be administered in three ways:

Jet into a vein. For such injections, water for injection is added to the powder in a volume of 5 ml (if the bottle contains 250-500 mg) or 10 ml (if the bottle contains 1 g). The introduction should be done slowly - over two to four minutes.
Drip into a vein. Such injections are usually prescribed, if necessary, to administer a large dose of Ceftriaxone (more than 50 mg / kg). The contents of the vial are diluted with 40 ml of a solution of glucose, sodium chloride or another preparation for intravenous infusion that does not contain calcium. The dropper is placed for at least 30 minutes.
Intramuscularly. Since such injections are very painful, "Lidocaine" or "Novocaine" is used as a solvent, after making sure that there is no allergy to such an anesthetic. To dilute 0.25-0.5 g of powder, 2 ml of liquid are used, for 1 g - 3.5 ml of anesthetic solution. Do not inject more than 1 g of antibiotic at a time into muscle tissue. It is recommended to inject the drug in a place where the muscles are more pronounced (shoulder, buttock, thigh) and change it for the next injection.

For injections, it is recommended to use freshly prepared solutions, but if necessary, a diluted antibiotic (if the cork was not opened, but only pierced with a needle) can be refrigerated, but for no more than 12 hours, that is, until the next injection. In this case, you need to remove the medication from the refrigerator in advance so that it warms up a little before the injection.

The dosage of "Ceftriaxone" must be calculated for each child separately, as it depends on the age and the severity of the infection. If injections are prescribed to a newborn in the first 14 days of life, then 1 kg of his body weight per day requires from 20 to 50 mg of the drug. For babies over two weeks old and older children (up to 12 years of age or weighing less than 50 kg), the daily dosage of the drug will be 20-80 mg per kilogram. With severe diseases (for example, with bacterial meningitis), the dose is increased to 100 mg / kg per day.

If the drug is prescribed for a child who weighs more than 50 kg, use doses for adults. For such patients, Ceftriaxone is administered twice a day with an interval of 12 hours, 500-1000 mg, or once a day in a dose of 1-2 grams. The maximum daily dose for severe infections for adolescents is considered 4 grams of an antibiotic.

The duration of the course differs in different patients, since it is influenced by the severity and nature of the disease. For example, if a child has meningitis triggered by meningococcus, Ceftriaxone is prescribed for 4 days. For diseases provoked by streptococci, injections are used for at least 10 days. In Lyme disease, treatment continues for 14 days.

If Ceftriaxone is chosen as a prophylactic medicine for a child who is to undergo surgery, then the injection is given once 0.5-1.5 hours before the operation.

Overdose

If the dose of Ceftriaxone is too high, negative side symptoms such as headache or vomiting will appear or worsen.

Withdrawing the drug with its excessive concentration in the blood using hemodialysis will not work, therefore, in case of an overdose, only symptomatic measures are used.

Interaction with other medications

It is unacceptable to mix Ceftriaxone solution and any other antibiotics in one syringe. If the causative agent of the infection is a gram-negative bacterium, Ceftriaxone can be prescribed together with aminoglycosides (they will enhance each other's action), but they should be used separately.

Terms of sale

One or more vials of Ceftriaxone can only be purchased with a prescription, so first you need to consult a doctor who will assess the need for antibiotic therapy and determine the correct dosage. The price of the drug is influenced by the dosage of the powder, the number of bottles in the pack and the manufacturer. On average, for one bottle of domestic production, depending on the dose, you need to pay 20-50 rubles.

Storage features

The shelf life of the powder in sealed bottles is 2 years (sometimes 3 years) from the date of manufacture, which must be specified on the packaging. Until this period has expired, the medicine should lie in a place inaccessible to babies, where there are no direct rays of the sun, and the temperature does not exceed +25 degrees.

Reviews

There are many positive reviews about the treatment of children with Ceftriaxone. In them, the parents confirm that such an antibiotic worked well and helped to quickly cure otitis media, bronchitis, pyelonephritis, or another disease caused by harmful bacteria. The advantages of the drug include its wide range of antimicrobial effects, the ability to use at any age and a short list of contraindications, as well as its affordable cost.

There are few negative reviews about the use of Ceftriaxone, and most of them include complaints of side effects, for example, an allergic rash or diarrhea. The disadvantage of the medication is that it is produced only in injections - so that the drug does not harm, it should be properly diluted and injected, which mothers usually cannot cope with, so you have to resort to the help of health workers.

In addition, injections are very painful, so they are diluted with anesthetic, which increases the risk of an allergic reaction.

There are also reviews in which the drug is called ineffective, due to the resistance of bacteria to its active substance. In such situations, it was necessary to cancel Ceftriaxone and select another treatment for the child.

Analogs

If necessary, replace "Ceftriaxone" with another cephalosporin antibiotic the doctor will recommend a medication that is also third generation, for example:

Rocefin. This Swiss product also contains ceftriaxone as its disodium salt. It is presented in bottles of 250, 500 and 1000 mg. He, like Ceftriaxone, is prescribed from birth with the same indications and in the same doses.
"Cefotaxime". This antibiotic is also available in injectable form and can be used from birth, with the exception of intramuscular injections, which are prescribed from 2.5 years.

"Suprax". This medicine contains cefixime and comes in several forms. Granules for making sweet suspension with strawberry flavor are the most convenient for children. This type of antibiotic can be used from 6 months of age.
Lendatsin. This is another analogue containing ceftriaxone, which is produced by the Lek company from Slovenia. One bottle can contain 250 mg of active substance, 1 g or 2 g.
"Claforan". The action of such a drug is provided by cefotaxime. It is available in injectable form and can be used for intravenous injections at any age, and intramuscularly - from 2.5 years.

"Pancef". This medicine works thanks to cefixime and is most in demand in childhood in the form of granules. When combined with water, they produce an orange-flavored suspension that is approved for patients over six months old.
"Zedex". This ceftibutene-based drug is available in powder form, from which a cherry-flavored suspension is made. It is permissible to give it to babies over six months old. In addition, there is "Zedex" in capsules. In this form, the medication is used from the age of 10 with a body weight of more than 45 kg.

If you are allergic to Ceftriaxone, your child will have to take an antibiotic of another group. In such a situation, the doctor can prescribe "Sumamed", "Azithromycin", "Vilprafen Solutab", "Macropen" and other drugs. They all contain different active ingredients and differ in contraindications, age restrictions and other characteristics.