![]() ![]() The combination of ceftriaxone and cefoxitin was found to be antagonistic against P. However, synergy is less common against aminoglycoside-resistant and/or multidrug-resistant strains. aeruginosa in vitro (20 to 80% of tested strains). The combination of ceftriaxone and an aminoglycoside (amikacin, gentamicin, netilmicin or tobramycin) is synergistic against P. The reported activity of ceftriaxone against Pseudomonas aeruginosa varies widely, but generally at least 32 mg/L is required to inhibit most strains, and strains resistant to other antibiotics are even less sensitive. 90% of tested strains of most Enterobacteriaceae were inhibited by a ceftriaxone concentration of ⩽ 1 mg/L, but Enterobacter cloacae is less sensitive than most other Enterobacteriaceae (MIC 90s 0.5 to 25 mg/L). ![]() Cephalothin and cefamandole tend to be more active than ceftriaxone against most Gram-positive bacteria.Ĭeftriaxone exhibits both a wider spectrum and greater activity against Gram-negative aerobic bacteria than ‘first generation’ and ‘second generation’ cephalosporins, is generally more active than cefoperazone except against Pseudomonas aeruginosa, and is similar in activity to cefotaxime and moxalactam (latamoxef). However, Staphylococcus epidermidis is at most only moderately sensitive (MIC 90s 11.9 to 50 mg/L) and Streptococcus faecalis is resistant to ceftriaxone. Ceftriaxone is similar in activity to benzylpenicillin against Streptococcus pneumoniae and pyogenes, and is also active in low concentrations against other Streptococcus species ( Str. Both penicillin-sensitive and -resistant strains of Staphylococcus aureus are sensitive to ceftriaxone (MIC 90s 3 to 7 mg/L), but the drug is poorly active against methicillin- and oxacillin-resistant strains. If more widespread use confirms the safety and efficacy of ceftriaxone, it will offer an important alternative, particularly for the treatment of serious infections due to multidrug-resistant Gram-negative bacteria and in situations where the long half-life of the drug could result in worthwhile convenience and cost benefits.Īntibacterial Activity: Ceftriaxone has a broad spectrum of activity in vitro which includes Gram-positive and Gram-negative aerobic and some anaerobic bacteria. Few significant differences in response rates were found between therapeutic groups in these comparative studies, but larger well-designed studies are needed to more clearly assess the comparative efficacy of ceftriaxone and other antimicrobials, especially the aminoglycosides and other ‘third generation’ cephalosporins, and to confirm the apparent lack of serious side effects with ceftriaxone. In a few small trials the comparative efficacy of ceftriaxone and other antibacterials has been assessed in other types of infections and in perioperative prophylaxis in patients undergoing surgery. A single intramuscular dose of ceftriaxone has been compared with standard therapy for gonorrhoea due to non-penicillinase-producing and penicillinase-producing strains of Neisseria gonorrhoeae and shown to be highly effective. Results were also encouraging in a few patients with ear, nose and throat, intra-abdominal, obstetric and gynaecological infections, and adult meningitis, but conclusions are not yet possible as to the efficacy of the drug in these indications due to limited experience. In most of these types of infections once-daily administration appears efficacious. Ceftriaxone was effective in complicated and uncomplicated urinary tract infections, lower respiratory tract infections, skin, soft tissue, bone and joint infections, bacteraemia/septicaemia, and paediatric meningitis due to susceptible organisms. Ceftriaxone has been effective in treating infections due to other ‘difficult’ organisms such as multidrug-resistant Enterobacteriaceae. Although ceftriaxone has some activity against Pseudomonas aeruginosa, on the basis of present evidence it cannot be recommended as sole antibiotic therapy in pseudomonal infections. ![]() The activity of ceftriaxone is generally greater than that of the ‘first’ and ‘second generation’ cephalosporins against Gram-negative bacteria, but less than that of the earlier generations of cephalosporins against many Gram-positive bacteria. It is administered intravenously or intramuscularly and has a broad spectrum of activity against Gram-positive and Gram-negative aerobic, and some anaerobic, bacteria. Synopsis: Ceftriaxone 1 is a new ‘third generation’ semisynthetic cephalosporin with a long half-life which has resulted in a recommended once daily administration schedule. ![]()
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