E-CEF ( POWDER, INJECTION ) ( 250 mg )

• Serious infections due to sensitive bacteria, including septicaemia, pneumonia and meningitis
• Surgical prophylaxis
• Prophylaxis of meningococcal meningitis
• Gonorrhea
• Bone and joint infection.

Source : IAP Pediatric Drug Formulary
Neonates 50-75 mg/kg once daily IM/IV. Infuse over 10-30 min. Avoid in premature, acidotic or hyperbilirubinemic neonates. Children 50-75 mg/kg once daily IV/IM. Meningities loading dose 75mg/kg followed by 80-100mg/kg24 hrs once or divided 12hrly. Maximum 4gm/day. In severe renal failure reduce dose to a maximum of 2g or 50mg/kg. No dose adjustment required in hepatic impairment. If both hepatic and severe renal impairment monitor serum concentrations. In patients undergoing dialysis no supplemental dose required but serum concentration monitoring advisable.

Source : NFI National Formulary of India
Intramuscular and intravenous injection or infusion

Adult- Urinary tract infection, pneumonia, pelvic inflammatory disease, prophylaxis of surgical infections and meningitis: 4g initially once daily for 10 days or up to 72 h after fever disappears.

Typhoid: 4g daily for two days followed by 2g daily for next two days. 1 to 2g daily is used for any other type of condition.

Child- Meningitis: 75 to 100 mg/kg body weight for 7 to 9 days.

Typhoid: 5 mg/kg body weight for 7 days. 50 to 75 mg/kg body weight is used in case of any other condition (max 2g/day).

• Cephalosporin hypersensitivity
• Porphyria
• Neonates with jaundice, hypoalbuminaemia, acidosis or impaired bilirubin binding

• Penicillin sensitivity
• Severe renal impairment
• Hepatic impairment if accompanied by renal impairment
• Premature neonates
• May displace bilirubin from serum albumin
• Treatment longer than 14 days, renal failure, dehydration or concomitant total parenteral nutrition-risk of ceftriaxone precipitation in gallbladder
• Lactation (but appropriate to use)
• Pregnancy
• False positive urinary glucose (if tested for reducing substances) and false positive Coombs’ test
• Interactions
• Phrophylactic indication, patients with impaired vit K synthesis, monitoring of prothrombin time is recommended.

• Diarrhoea, nausea and vomiting, abdominal  discomfort, headache
• Antibiotic-associated  colitis (particularly with higher doses)
• Allergic reactions including rashes, pruritus,  urticaria, serum sickness-like reactions,  fever and arthralgia and anaphylaxis
• Erythema multiforme, toxic epidermal necrolysis reported
• Transient hepatitis and cholestatic jaundice
• Elevation of SGOT and SGPT
• Eosinophilia and blood disorders (including thrombocytopenia, leukopenia, agranulocytosis, aplastic anaemia and haemolytic anaemia)
• Reversible interstitial nephritis, hyperactivity, nervousness, sleep disturbances, confusion, hypertonia and dizziness
• Calcium ceftriaxone precipitates in urine (particularly in very young, dehydrated, or those who are immobilized) or in gall bladder-consider discontinuation if symptomatic
• Rarely, prolongation of prothrombin time, pancreatitis
• Local reaction, hypersensitivity.

Store protected from light at a temperature not exceeding 30⁰C