Ceftriaxone for acute and obstructive bronchitis: dosage, course of treatment

Treatment of bronchitis Ceftriaxone is carried out in cases of proven or suspected bacterial origin of the inflammatory process in the bronchi, requiring the use of antibacterial drugs.

Does Ceftriaxone help with bronchitis? If the cause of bronchitis are not viruses, and bronchitis is not allergic, it is the third generation cephalosporin antibiotics, to which Ceftriaxone belongs (the other trade names - Cefatrine, Cefaxon, Betasporin, Longacef, Rocefin, Epicefine) are the fastest curing microbial infections. For more details see  Antibiotics for bronchitis

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Indications of the ceftriaxone for bronchitis

Ceftriaxone is used:

• at an acute bronchitis, at a chronic bronchitis and at an obstructive bronchitis, the reason of development of which are gram-positive and gram-negative bacteria (aerobic and anaerobic);
• infectious pneumonia (including abscess);
• acute bacterial otitis (caused by Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, etc.);
• bacterial meningitis caused by Neisseria meningitidis, Streptococcus pneumoniae or Haemophilus influenzae (including strains producing beta-lactamase);
• infections of the skin and subcutaneous tissues;
• infectious diseases of the urinary tract and pelvic organs (provoked by bacteria Escherichia coli, Proteus mirabilis, Proteus vulgaris, Morganella morganii, Chlamydia trachomatis, Klebsiella spp.);
• uncomplicated gonorrhea;
• postoperative pyo-septic complications, including septicemia and septicopyemia;
• tick-borne borreliosis.

Ceftriaxone is not used for diseases caused by Enterobacter spp.

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Release form

Ceftriaxone is available only in the form of a crystalline powder (in 500 mg, 1 and 2 g flasks) for the preparation of a solution intended for parenteral administration.

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Pharmacodynamics

Ceftriaxone acts bacterically - by selective binding to transamidase bacteria (catalyzing the cross-linking of bacterial cell-forming peptidoglycan polymers) and irreversible inhibition of their synthesis, which leads to damage to cell membranes and the death of microorganisms.

Ceftriaxone is active against the protective beta-lactamases of various microorganisms - penicillinase and cephalosporinase, which broadens the spectrum of its antibacterial action.

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Pharmacokinetics

When administered intramuscularly Ceftriaxone is completely adsorbed by the tissues and quickly enters the systemic circulation, 90% bound to proteins; the bioavailability level is 100%.

When does ceftriaxone start with bronchitis? According to the instructions, 90 minutes after the IM injection of the drug, its maximum concentration in the blood plasma is reached. In this case, the therapeutically active amounts of Ceftriaxone remain in the tissues of organs and body fluids (pleural, synovial, etc.) for at least 24 hours.

From the body, the drug is excreted in the urine (55-65%) and feces (35-45%) with an average half-life of 7-9 hours.

There is a longer delay in ceftriaxone in the body of the elderly, young children and patients with renal insufficiency.

[11], [12], [13], [14]

Dosing and administration

Ceftriaxone is used parenterally, that is, intramuscular injections of ceftriaxone are prescribed for bronchitis.

The usual daily dose of Ceftriaxone in adults (and children over 12 years of age) is 1-2 g, administered once a day or in equal doses twice a day, depending on the type and severity of the infection. The total daily dose should not exceed 4 g.

Ceftriaxone in bronchitis in children under 12 years of age is prescribed in a dosage determined by body weight: 25-75 mg per kilogram, administered once a day (or twice in equal amounts). The maximum allowable daily dose is 2 g.

How many days to prick the Ceftriaxone in bronchitis? The course of ceftriaxone in bronchitis is determined individually, but the standard duration of treatment is 7 days.

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Use of the ceftriaxone for bronchitis during pregnancy

Although Ceftriaxone, according to official figures, does not have a teratogenic effect on the fetus, it is not prescribed in the first three months of pregnancy. At later dates, the physician should assess the risk ratio of its possible side effects and the appropriateness of the application. The use of Ceftriaxone for lactating women requires the abolition of breastfeeding.

More information -  Cephalosporins in pregnancy

Contraindications

Ceftriaxone is contraindicated in cases of hypersensitivity in beta-lactam antibiotics, decreased liver and / or kidney function, and hyperbilirubinemia in newborns.

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Side effects of the ceftriaxone for bronchitis

Although in general, Ceftriaxone is well tolerated in bronchitis, among its most frequent side effects are: changes in the blood (eosinophilia, thrombocytosis, leukopenia), rash and diarrhea and local reactions at the site of administration.

Nausea, vomiting, increased bilirubin and creatinine in the blood are much less common. Also, Ceftriaxone can precipitate in the bile (especially in children), causing pseudolithiasis of the bile ducts and the formation of convolutions in the gallbladder.

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Overdose

A prolonged excess of Ceftriaxone dosage can lead to accelerated destruction of red blood cells (hemolytic anemia), a decrease in the number of leukocytes and platelets, as well as agranulocytosis.

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Interactions with other drugs

Do not concurrently use ceftriaxone with intravenous solutions containing calcium; antibiotics of the group of aminoglycosides and fluoroquinolones; nonsteroidal anti-inflammatory drugs; salicylates; anticoagulants and diuretic-sulfonamides and ethacrynic acid derivatives.

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Storage conditions

Ceftriaxone should be stored in a dark place at room temperature.

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Shelf life

Shelf life of the drug in unopened vials is 24 months.

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Reviews

The data of the Cochrane reviews and the reviews of Russian pulmonologists and physicians of other specializations testify to the use of Ceftriaxone in a wide range of bacterial diseases.

Many people are interested in the level of effectiveness of this drug in bronchitis in comparison with other antibiotics of the cephalosporin group. For example, what is better with bronchitis - Cefazolin or Ceftriaxone? Cefazolin is a first-generation cephalosporin, it does not act on Haemophilus influenzae, and it is not prescribed for sinusitis, otitis, bronchitis, and community-acquired pneumonia, but is used in the treatment and prevention of postoperative infections (for cardiac, vascular, gastrointestinal and pelvic interventions).

In cases of bacterial inflammation of the nasopharynx, middle ear and respiratory tract, it is Ceftriaxone that is prescribed, because with its high antibacterial activity, this drug and its analogues - the third generation cephalosporins Ciprofloxacin, Cefotaxime, Cefaxon, Tsebopim, Cerazon, etc. - rarely cause side effects and act faster.

What is better, Ceftriaxone or Cefotaxime in bronchitis? In the review, there is no clinically significant difference between the third generation cephalosporins, and Cefotaxime is used in the same infections as Ceftrthiaxone. However, pharmacists know that the advantage of Ceftriaxone is that in its structure, instead of the unstable acetyl group of Cefotaxime, there is a more metabolically stable tiotriazindione fragment that increases resistance to resistant Gram-negative bacteria.