PHARMACOKINETICS AND EFFICACY OF ONCE DAILY CEFTRIAXONE

Abstract

Because of its spectrum and prolonged half-life ceftriaxone (RO) has been shown to be particularly useful in the treatment of pediatric infections including meningitis. In the United States it has been administered twice daily and the major side effect encountered has been diarrhea. RO 50mg/kg, administered once daily, was used to treat 18 non-meningitic infections in children aged 2.5 M to 13 yr. Etiologic agents included Staphylococcus aureus (9), Streptococcus pyogenes (8), non-enterococcal group D Streptococcus (1), Hemophilus influenzae b (3) (1 ampicillin resistant), Klebsiella pneumoniae (2), E. coli (2), Proteus vulgaris (1). Several patients had 2 organisms isolated. Infections seen included cellulitis (13)-periorbital (3), septicemia (2), urinary tract infections (4), epiglottitis (1). One patient had both a UTI and septicemia. Duration of therapy ranged from 5 to 9 days. The mean plasma RO concentrations obtained one hour after and within one hour before a dose were 193.8 ± 101μg/ml and 8.6 ± 6μg/ml. The mean half-life was 5.13 h ± 1.05. All patients had trough RO concentrations ⩾ 3.4μg/ml exceeding the minimal inhibatory concentration of the infecting organism. All patients were cured. No patients developed diarrhea although 2 patients had eosinophilia, 2 thrombocytosis and 3 elevated transaminases. Ceftriaxone appears safe and effective when used at the lower dose of 50mg/kg administered once daily to treat infections with susceptible organisms.

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