Ceftriaxone for sore throat in adults and children: how to treat correctly?

Tonsillitis is a very common disease that can strike both in cold and warm seasons. Such a disease can "knock" a person out of the rut for several days: work capacity is impaired, health significantly worsens. Therefore, many sick people are interested in: what antibiotics and how can you take them in order to recover from the disease as quickly as possible and not harm yourself? For example, can you choose Ceftriaxone for tonsillitis - after all, it is a fairly powerful antibiotic, and how to properly treat it with this drug?

Will Ceftriaxone help with sore throat?

Today, doctors use the following therapeutic approach for sore throat. Antibiotic therapy is prescribed only if there are clear indications, when there is laboratory confirmation of the bacterial origin of the disease. After all, the unjustified use of antibacterial agents has reached epidemic proportions over the past few decades: the drugs are often “prescribed” to themselves by patients or pharmacists who do not have the necessary qualifications to prescribe treatment.

The widespread use of antibiotics has led to the fact that microbes are becoming increasingly resistant to such drugs. According to statistics, the degree of resistance of β-hemolytic streptococcus A to macrolide drugs is already at least 10%. Microbes also have significant resistance to tetracyclines, so these drugs are not recommended for use in sore throats. In the current situation, it is optimal to use β-lactam antibiotics for sore throats caused by the effect of β-hemolytic streptococcus A, which include drugs of the penicillin and cephalosporin groups. In particular, Ceftriaxone is used quite often for sore throats, since this antibiotic belongs to the cephalosporin representatives of the third generation and, among other things, has a prolonged effect.

Is it possible to inject Ceftriaxone when you have a fever?

If the temperature rises with angina, and the doctor has prescribed Ceftriaxone, then it can and even should be injected. But only in cases where the angina is caused by bacterial flora that is sensitive to the effects of Ceftriaxone, or in the development of secondary bacterial complications.

By the way, angina is accompanied by a slight increase in temperature in almost all patients - on average up to 38-39 ° C. This is due to the infectious nature of the disease. Most often, the temperature rises against the background of the formation of purulent secretion in the tonsils, which is typical for lacunar and follicular angina. As a rule, febrile or subfebrile temperature does not bother the patient for long: its gradual decrease is observed already on the second or third day from the onset of the disease. The average duration of the high-temperature period is 1-3 days.

If you do not take Ceftriaxone for sore throat, or another antibiotic prescribed by the doctor, then the high temperature can last longer. Especially often, prolonged high temperature values indicate the development of various complications.

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Treatment of angina with Ceftriaxone

As we have already noted, the use of Ceftriaxone for angina is justified only in two cases:

• if the sore throat has a proven bacterial etiology;
• if there are secondary bacterial complications.

It is equally important that the bacteria be sensitive to the effects of Ceftriaxone.

It is important to remember that viral tonsillitis cannot be cured with antibiotics: while the patient is waiting for the effect, taking an unnecessary antibacterial drug, the virus will continue its active reproduction and affect new tissues, simultaneously releasing dangerous toxic substances. Therefore, Ceftriaxone is only suitable for the treatment of bacterial tonsillitis.

It should also be taken into account that Ceftriaxone, like any other antibiotic, does not affect the symptoms of the disease: it does not eliminate headaches, sore throats, runny noses, etc. Therefore, to achieve a faster recovery effect, you should also take other medications - for example, analgesics, antipyretics, vitamins, etc.

Only a doctor has the right to decide whether to treat a sore throat with Ceftriaxone or any other drug. Moreover, an antibiotic should be prescribed only if the bacterial nature of the sore throat is established, and never just like that or for prevention.

Indications Ceftriaxone

Ceftriaxone is prescribed not only for sore throat. This antibiotic can be used to treat other infections if the causative bacteria is sensitive to it:

• infectious diseases of the respiratory system (ENT diseases, pneumonia);
• infectious lesions of the abdominal organs (inflammation of the hepatobiliary system, digestive tract, peritonitis);
• infectious lesions of the genitourinary system;
• sexually transmitted infections (eg, gonorrhea);
• septic conditions;
• infectious lesions of the musculoskeletal system, wounds and other infected soft tissue injuries;
• meningitis.

Ceftriaxone for bacterial tonsillitis is used for the following diagnoses:

• Follicular tonsillitis (occurs with the formation of small pustules on the tonsils, the diameter of a match head).
• Lacunar tonsillitis (characterized by the accumulation of purulent secretions in the lacunae, high temperature up to 40°C, severe pain in the throat).
• Acute paratonsillitis, or phlegmonous angina (not only the tonsils are affected, but also the peritonsillar tissue, with the formation of a phlegmonous lesion).

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Ceftriaxone for purulent tonsillitis

Purulent tonsillitis is a conventional term used to describe acute tonsillitis in cases where there is purulent secretion on the tonsils. Thus, both follicular and lacunar tonsillitis may be meant. Purulent tonsillitis always causes more discomfort to patients, as its course is especially severe: severe pain in the throat and head, enlargement and soreness of the submandibular lymph nodes, fever are observed.

If purulent tonsillitis occurs in one family member, then usually the rest of its members get sick too – the disease is a highly contagious infection. Treatment of such a disease necessarily includes taking an antibiotic – for example, Ceftriaxone. In addition, gargling is mandatory – to speed up the removal of purulent secretion from the oropharynx. Additionally, analgesics, antipyretics, and vitamins are taken.

During the first few days after the onset of the disease, it is imperative to adhere to bed rest. This way, Ceftriaxone for sore throat will act faster, and the disease will subside.

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Release form

Ceftriaxone, which is often used for sore throat, is a finely crystalline powder of white or slightly yellowish hue. The bottle may contain 0.5 or 1 g of ceftriaxone sodium salt (converted to ceftriaxone). The powder is used to prepare an injection solution.

This feature of the dosage form has both advantages and disadvantages.

• Advantages of the injectable form of antibiotics for sore throat:

1. the active component enters the body in a “pure” form, without auxiliary components and dyes, which can become additional allergens;
2. the action of the injectable antibiotic is faster;
3. the injection can be given to a patient who has a high temperature or is vomiting, which makes treatment with tablets difficult;
4. the administration of the drug is controlled by a medical specialist (for example, it is more difficult to control the intake of a pill: the patient, especially a child, can cheat, spit out the drug, etc.).

• The disadvantages of this dosage form are as follows:

1. an injection is always more painful than taking a pill;
2. the patient will not always be able to administer Ceftriaxone to himself for sore throat;
3. Sometimes injection is complicated by the formation of a seal and the development of an abscess.

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Pharmacodynamics

Ceftriaxone, which can be prescribed to a patient with angina, is considered one of the basic representatives of third-generation cephalosporin antibacterial drugs. The drug is administered parenterally (by injection), due to which a rapid bactericidal effect of the antibiotic is achieved.

Ceftriaxone inhibits the development of many Gram (+) and Gram (-) bacteria and exhibits resistance to β-lactamase enzymes produced by most microbes.

Ceftriaxone has been proven to be effective against the following pathogens:

• Gram (+) staphylococci, streptococci (except staphylococcus spp. and faecalis);
• Gram (-) aeromonads, eubacteria alkaligenes, branhamella, citrobacteria, Escherichia coli, Haemophilus influenzae, Klebsiella, Moraxella, Morganella, Neucheria, Proteus, pseudomonas, Salmonella, Shigella, etc.

The antibiotic inhibits the processes of bacterial cell wall synthesis, which explains the bactericidal property of Ceftriaxone for sore throat.

How fast does Ceftriaxone work?

When an antibiotic is administered intramuscularly, the active ingredient is absorbed into the bloodstream gradually, but still faster than when the tablet form is taken orally. When it enters the circulatory system, the antibiotic passes through the liver and accumulates in the blood and tissues of the body in various concentrations.

It is believed that the effect of Ceftriaxone in sore throat should be assessed approximately 2 days after the start of treatment, since the effect makes itself known only after 2-3 days. Do not count on the immediate effect of the drug: the antibiotic will not be able to destroy all pathogenic bacteria in a matter of seconds.

Each antibacterial drug has its own specific period of action. And each time the concentration of the drug in the blood decreases, it must be replenished. This means that Ceftriaxone for sore throat must be administered strictly according to the schedule, daily at the same time. If you follow this principle, the bacteria will be destroyed, and the desired relief will soon come. If you skip injections or take treatment at different times, resistant strains of the pathogen may form: the disease will drag on, you will have to take a second course of antibiotics with a replacement of the main drug.

If a positive effect from antibiotic therapy is detected on the 2nd-3rd day, then in no case should you immediately stop the treatment: bacteria still remain in the body, and if the treatment is stopped, they will make themselves known again. Therefore, the period of therapy indicated by the attending physician must be completed in full (for example, this can be seven or ten days).

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Pharmacokinetics

When Ceftriaxone is injected for sore throat, it fully penetrates into tissues and fluids. When testing the drug in adults, a long, about eight hours, half-life was noted. The biological availability of the antibiotic after injection is determined to be 100%.

The bactericidal effect on sensitive flora can last for 24 hours.

The half-life in a healthy adult is eight hours. In infants within a week of birth and in the elderly over 75 years of age, the average half-life may be 16 hours.

In middle-aged patients, more than 50% of active ceftriaxone is excreted unchanged in urine. Slightly less – about 45% – is excreted in bile.

Under the influence of intestinal microflora, ceftriaxone is transformed into an inactive substance. In infants, during the first month of life, about 70% of the administered antibiotic is excreted by the kidneys.

In adult patients with impaired renal or hepatic function, the kinetic characteristics of ceftriaxone remain virtually unchanged. Thus, in renal failure, the excretion of the antibiotic with bile increases, and in liver disease, excretion through the kidneys is activated.

Ceftriaxone binds back to proteins, the content of the antibiotic in the interstitial fluid exceeds the concentration in plasma.

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Dosing and administration

For an adult patient, as well as a child starting from 12 years of age, the daily dose of Ceftriaxone is 1 g. In severe cases of the disease, the dosage can be increased to 2-4 g.

For intramuscular injection, the powder should be dissolved in sterile water for injection. The following formula is used for this:

• 0.5 g of Ceftriaxone powder – 2 ml of solvent;
• 1 g of Ceftriaxone powder – 3.5 g of solvent.

How many times a day should I inject Ceftriaxone and how many days should I inject it for sore throat?

The antibiotic is administered once a day, every day at the same time. The duration of therapy is not always constant: the course of treatment can last from 5 to 10 days. It is generally accepted that Ceftriaxone for angina should be used until the main symptoms of the disease disappear, plus three more days.

The antibiotic is injected deep into the upper-outer gluteal quadrant. It is not advisable to inject more than 1 g of the drug into one gluteal area. To prevent pain during intramuscular injections, 1% lidocaine may be used as a solvent.

Newborn infants up to 2 weeks of age are administered 20 to 50 mg/kg of body weight per day.

Infants and children under 12 years of age are administered 20 to 75 mg/kg of weight daily. If the child weighs more than 50 kg, the amount of Ceftriaxone is calculated according to the scheme for adults.

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Ceftriaxone for sore throat in adults

When choosing an antibiotic for treating tonsillitis, the doctor should first of all pay attention to the diagnostic results. A bacterial culture is done in advance: a smear is taken from the tonsils, sent to laboratory technicians, who sow it on the appropriate nutrient medium. After a while, colonies of microbes germinate, and in the laboratory, specialists determine their species and degree of sensitivity to antibacterial drugs.

Bacterial culture is a standard diagnostic procedure and helps to accurately determine which microbe is the causative agent of the disease.

In practice, many doctors prefer to immediately prescribe one of the antibiotics with the widest spectrum of antimicrobial activity - primarily in order not to waste time on bacterial culture and waiting for the result. Ceftriaxone is one of such "universal" antibiotics. However, this approach is not always correct. Today, there are also express methods for identifying the pathogen in a smear: the result can be obtained in 10 minutes. Unfortunately, such tests are not available in all medical institutions.

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Application for children

Penicillin group drugs are usually prescribed for a child with tonsillitis: they are effective and easily tolerated by pediatric patients. As for cephalosporins, these antibiotics are prescribed to children only in a few cases:

• if it is impossible to use penicillins and macrolides for treatment;
• for complex, protracted tonsillitis prone to complications;
• when treatment with other antibacterial groups is ineffective.

Tonsillitis is most often caused by streptococci and staphylococci, but viral and mycotic origins of the disease are not excluded - this is necessarily taken into account, and laboratory diagnostics are carried out before the start of treatment. Pathogenic microorganisms are able to actively multiply under favorable conditions for them, which are created against the background of childhood fatigue, poor nutrition, frequent colds and viral diseases.

You should never give your child such a powerful antibiotic as Ceftriaxone on your own: this can lead to the development of a superinfection. In addition, it is quite difficult for children to select a medication and calculate the dosage, which depends on the specific pathogen causing the sore throat, the severity of the disease, the body weight and age of the sick child. Prescribing Ceftriaxone to a child for sore throat is a balanced step that only a doctor can take.

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Use Ceftriaxone during pregnancy

The period of pregnancy is very difficult - and not only for the woman herself, but also for doctors. After all, the expectant mother is not insured against various diseases during this period, including tonsillitis. But taking antibiotics at this stage is highly undesirable.

What about the prescription of Ceftriaxone for angina? For pregnant patients, this medication is allowed only in extreme situations, and only in the second half of pregnancy. The first trimester is the most undesirable time for treatment with Ceftriaxone. In addition, the drug is not prescribed for hypersensitivity to cephalosporin drugs, with impaired renal function.

A woman should stop treating her sore throat with Ceftriaxone if she experiences unwanted symptoms such as nausea, fever, rash, redness of the skin, or nosebleeds.

In general, if Ceftriaxone for sore throat was prescribed during the second or third trimester, and the attending physician constantly monitored the course of pregnancy, then complications after therapy should not arise. The main thing is to trust your doctor and consult with him on any current issues.

Contraindications

Ceftriaxone cannot be prescribed for tonsillitis if:

• the patient suffers from hypersensitivity to antibacterial drugs of the cephalosporin and penicillin groups;
• the patient is in the first trimester of pregnancy or is breastfeeding;
• The patient suffers from combined renal and hepatic insufficiency.

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Side effects Ceftriaxone

The most common side effects during treatment of sore throat with Ceftriaxone are:

• frequent loose stools, nausea, development of stomatitis and glossitis;
• in the blood thrombocytopenia, eosinophilia, leukopenia, hemolytic anemia;
• skin exanthema, allergic dermatitis, edema;
• headaches, dizziness;
• bile stasis, increased activity of liver enzymes;
• fungal infections of the genitals;
• allergic processes.

Local side effects may include the formation of an infiltrate and pain in the area of Ceftriaxone injections.

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Overdose

Long-term therapy with Ceftriaxone may result in changes in the blood picture: signs of leukopenia, hemolytic anemia, neutropenia, thrombocytopenia are noted.

An increase in side effects is also possible.

Treatment of overdose is carried out according to the symptoms that have arisen. If necessary, hemodialysis or peritoneal dialysis is connected.

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Interactions with other drugs

Ceftriaxone should not be administered in the same syringe with other antibacterial drugs due to pharmaceutical incompatibility.

Ceftriaxone, like other antimicrobial agents, inhibits the development of intestinal microflora, simultaneously suppressing the production of vitamin K. The simultaneous use of nonsteroidal anti-inflammatory drugs or sulfinpyrazone may lead to an increased risk of bleeding. The same can be said about the combined treatment with Ceftriaxone and anticoagulants.

The combination of antibiotics and loop diuretics increases the load on the kidneys – a nephrotoxic effect is possible.

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Storage conditions

Vials with Ceftriaxone are stored without removing them from the cardboard packaging, in a dark, dry place with a temperature of +8 to +25°C. The place where the medicines are stored must be protected from children's access.

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Shelf life

Vials with Ceftriaxone are stored for up to 2 years (counted from the date of manufacture). After this period, or if the integrity of the vials is damaged, the medicine is disposed of.

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Analogues

Ceftriaxone is a drug of ceftriaxone sodium salt. There are many analogues of this drug, and they all have different names with the same active component, for example:

• Abitrax
• Alcison
• Bresek
• Efmerin
• Loraxson
• Emsef
• Cefotriz
• Cefodar
• Cefaxon
• Rocephin
• Tercef
• Cefogram
• Promocef
• Oframax
• Noraxone
• Medaxon
• Lendacin
• Lavakson
• Avexon
• Belcef, etc.

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Reviews

Using the "wrong" medications for sore throat is no less dangerous than no treatment at all. Patients with sore throat should avoid two extremes:

• take antibiotics for any illness and even just for prevention;
• ignore any treatment and endure the disease "on your feet".

It is also not recommended to choose a medication yourself, using the services of the Internet or a pharmacist from the nearest drugstore. For example, only your attending physician, who has previously studied the results of your tests, can prescribe such a powerful drug as Ceftriaxone for sore throat.

According to reviews, Ceftriaxone is indeed a very effective drug. However, many users note that injections are very painful. Therefore, it is still worth considering and using as a solvent not ordinary water for injections, but a lidocaine solution.

Few people know, but antibiotic therapy helps not only to cope with the infection: the patient becomes much less contagious after the first injection of Ceftriaxone. The use of the drug is especially relevant for purulent forms of tonsillitis.

It should not be forgotten that an illiterate approach to therapy often entails the development of complications and aggravation of pathology. The transformation of angina into a chronic process is especially common.

Despite the fact that the instructions for the medication indicate a large list of side effects, experts note that unpleasant symptoms are extremely rare. Therefore, you should not be afraid to take Ceftriaxone if there are indications: the list provided in the instructions is just a warning for the patient about any, even the most unlikely, background symptoms. And this does not mean that they will necessarily be.

In general, most doctors recommend the use of Ceftriaxone injections for tonsillitis, especially for purulent forms of the disease.

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