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

Treatment of bronchitis with 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 is not viruses, and bronchitis is not allergic, then it is the third-generation cephalosporin antibiotics, which include Ceftriaxone (other trade names are Cefatrin, Cefaxone, Betasporin, Longacef, Rocefin, Epicefin) that cope with microbial infections the fastest. For more information, see - Antibiotics for bronchitis

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Indications ceftriaxone for bronchitis

Ceftriaxone is used:

• in acute bronchitis, chronic bronchitis and obstructive bronchitis, the cause of which are gram-positive and gram-negative bacteria (aerobic and anaerobic);
• infectious inflammation of the lungs (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 beta-lactamase-producing strains);
• infections of the skin and subcutaneous tissues;
• infectious diseases of the urinary tract and pelvic organs (caused by the bacteria Escherichia coli, Proteus mirabilis, Proteus vulgaris, Morganella morganii, Chlamydia trachomatis, Klebsiella spp.);
• uncomplicated gonorrhea;
• postoperative purulent-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 crystalline powder (in vials of 500 mg, 1 and 2 g) for the preparation of a solution intended for parenteral use.

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Pharmacodynamics

Ceftriaxone acts bactericidally by selectively binding to bacterial transamidases (catalyzing the cross-linking of peptide glycan polymers that form the bacterial cell wall) and irreversibly inhibiting their synthesis, which leads to damage to cell membranes and the death of microorganisms.

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

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Pharmacokinetics

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

When does Ceftriaxone start to work for bronchitis? According to the instructions, 90 minutes after the intramuscular injection of the drug, its maximum concentration in the blood plasma is reached. At the same time, therapeutically active amounts of Ceftriaxone are retained in the tissues of organs and body fluids (pleural, synovial, etc.) for at least 24 hours.

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

A longer retention of Ceftriaxone in the body is observed in the elderly, young children and in patients with renal insufficiency.

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Dosing and administration

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

The usual daily dose of Ceftriaxone for bronchitis 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 for 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 permissible daily dose is 2 g.

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

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Use ceftriaxone for bronchitis during pregnancy

Although Ceftriaxone, according to official data, does not have a teratogenic effect on the fetus, it is not prescribed in the first three months of pregnancy. At later stages, the doctor must evaluate the risk of its possible side effects and the appropriateness of use. The use of Ceftriaxone in lactating women requires the cessation of breastfeeding.

More information - Cephalosporins during pregnancy

Contraindications

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

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Side effects ceftriaxone for bronchitis

Although Ceftriaxone is generally well tolerated for bronchitis, its most common side effects include: changes in the blood (eosinophilia, thrombocytosis, leukopenia), rash and diarrhea, and local reactions at the injection site.

Much less frequently, nausea, vomiting, increased bilirubin and creatinine in the blood may occur. Ceftriaxone may also precipitate in bile (especially in children), causing pseudolithiasis of the bile ducts and the formation of stones in the gallbladder.

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Overdose

Long-term overdose of Ceftriaxone may result in accelerated destruction of red blood cells (hemolytic anemia), decreased white blood cell and platelet counts, and agranulocytosis.

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Interactions with other drugs

Concomitant use of Ceftriaxone with intravenous solutions containing calcium; antibiotics of the aminoglycoside and fluoroquinolone groups; non-steroidal anti-inflammatory drugs; salicylates; anticoagulants and diuretics-sulfonamides and ethacrynic acid derivatives is not allowed.

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Storage conditions

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

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Shelf life

The shelf life of the drug in unopened bottles is 24 months.

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Reviews

Data from Cochrane reviews and reviews from domestic pulmonologists and doctors of other specialties indicate the use of Ceftriaxone in a wide range of diseases of bacterial origin.

Many people are interested in the level of effectiveness of this drug for bronchitis in comparison with other antibiotics of the cephalosporin group. For example, which is better for 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 (during interventions on the heart, blood vessels, gastrointestinal tract and pelvic organs).

For bacterial inflammations of the nasopharynx, middle ear and respiratory tract, Ceftriaxone is prescribed, since with its high antibacterial activity, this drug and its analogues - third-generation cephalosporins Ciprofloxacin, Cefotaxime, Cefaxone, Cebopim, Cerazon, etc. - are less likely to cause side effects and act faster.

Which is better, Ceftriaxone or Cefotaxime for bronchitis? The review does not show a clinically significant difference between third-generation cephalosporins, and Cefotaxime is used for the same infections as Ceftriaxone. However, pharmacists know that the advantage of Ceftriaxone is that its structure contains a more metabolically stable thiotriazinedione fragment instead of the unstable acetyl group of Cefotaxime, which increases resistance to resistant gram-negative bacteria.