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Cefaxona

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Indications:

Acute bacterial otitis media ( Rocephin ); treatment of infections of lower respiratory tract, skin and skin structures, bone and joint, and urinary tract; treatment of pelvic inflammatory disease, intra-abdominal infections, gonorrhea ( Rocephin ), meningitis, and septicemia caused by susceptible microorganisms; preoperative prophylaxis. Unlabeled Uses Neurologic complications, arthritis, and carditis associated with Lyme disease in patients refractory to penicillin G.

Contraindications:

Hypersensitivity to cephalosporins; neonates (28 days of age or younger); concomitant use with calcium-containing IV solutions, including continuous calcium-containing infusions, such as parenteral nutrition in neonates.

Adverse reactions:

GI Diarrhea (2%). Hematologic-Lymphatic Eosinophilia (6%); thrombocytosis (5%); leukopenia (2%). Lab Tests Elevated ALT and AST (3%); elevated BUN (1%). Local Induration/tightness/warmth (17%); induration/pain/tenderness (1%). Miscellaneous Fatal ceftriaxone-calcium precipitates in lung and kidneys of neonates.

Interactions:

Aminoglycosides Increased risk of nephrotoxicity. Anticoagulants (eg, heparin, warfarin) Risk of bleeding may be increased. Cyclosporine Elevated cyclosporine levels with increased risk of toxicity may occur. Incompatibility Other antimicrobial drugs. Laboratory Test Interactions None well documented.

Warnings:

Monitor Periodically measure plasma levels of the drug in patients with impaired renal function. If evidence of drug accumulation is present, adjust the dose accordingly. In patients with both hepatic function impairment and renal disease, closely monitor ceftriaxone plasma concentrations. Monitor PT in patients with impaired vitamin K synthesis or low vitamin K stores. Adverse reactions Monitor patient for GI, skin, and general body adverse reactions and signs of superinfection. Instruct patient to inform health care provider if noted and significant, and to immediately report severe diarrhea, diarrhea containing blood or pus, or severe abdominal cramping. Response to therapy Monitor patient’s response to therapy. Pregnancy Category B . Lactation Excreted in breast milk. Children Cephalosporins may accumulate in newborns. Hypersensitivity Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible cross-reactivity. Renal Function No dosage adjustment is needed in patients with renal failure who are receiving usual doses of ceftriaxone. Hepatic Function No dosage adjustment is needed in patients with hepatic function impairment; however, in patients with both hepatic function impairment and renal disease, the dosage should not exceed 2 g daily without close monitoring of serum concentrations. Superinfection May result in bacterial or fungal overgrowth of nonsusceptible microorganisms. Calcium-containing products Because of the possibility of precipitation of ceftriaxone calcium, do not administer ceftriaxone and a calcium-containing IV solution simultaneously. In patients other than neonates, ceftriaxone and calcium-containing solutions may be administered sequentially if the infusion lines are flushed with a compatible fluid between infusions. Prothrombin time Alterations in PT may occur. Pseudomembranous colitis Consider in patients in whom diarrhea develops. Sonographic abnormalities Sonographic abnormalities in the gallbladder, with symptoms of gallbladder disease, have been reported.

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Consultants Corner

Dr. Samer Al-Jneidy

Dr. Samer Al-Jneidy Pediatrician

Samir Moussa M.D.

Samir Moussa M.D. ENT Specialist

Dr. Faisal Dibsi

Dr. Faisal Dibsi Specialist of Otolaryngology - Head and Neck Surgery

Dr. Hani Najjar

Dr. Hani Najjar Pediatrics, Neurology

Dr. Tahsin Martini

Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

Dr. Talal Sabouni

Dr. Talal Sabouni UROLOGY AND KIDNEY TRANSPLANT

Dr . Dirar Abboud

Dr . Dirar Abboud Hepatologist – Gastroenterologist

Yaser Habrawi , F.R.C.S.Ed

Yaser Habrawi , F.R.C.S.Ed Consultant Ophthalmologist

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