Cefotaxime is preferred in neonates due to the risk of bilirubin encephalopathy (kernicterus) and fatal reactions caused by calcium-ceftriaxone precipitates.
Empiric therapy of bacterial meningitis, complicated community acquired pneumonia, nosocomial Gram negative infections (except Pseudomonas)
Allergy,rash (immediate or delayed)
Hepatic (biliary) and renal laboratory abnormalities
Calcium containing IV solutions bind to ceftriaxone forming an insoluble precipitate- avoid concurrent use with calcium containing solutions in neonates.
Ceftriaxone should not be mixed with calcium-containing IV solutions, including TPN and Ringer’s solution.
IM ceftriaxone may be given with 1% lidocaine to minimize pain at injection site
Antimicrobial class: Parenteral Cephalosporin - 3rd Generation
Average serum half life:
Neonates: 1-4 days: 16 hours; 9-30 days: 9 hours
Route of Elimination: Unchanged in the urine (33-67%) by glomerular filtration and in feces via bile.