Ceftriaxone (Rocephin)

How does it work?

Rocephin injection contains the active ingredient ceftriaxone, which is a type of medicine called an antibiotic. Ceftriaxone is a type of antibiotic called a cephalosporin. These antibiotics are related to penicillin. Ceftriaxone is used to treat infections with bacteria.

Ceftriaxone works by interfering with the ability of bacteria to form cell walls. The cell walls of bacteria are vital for their survival. They keep unwanted substances from entering their cells and stop the contents of their cells from leaking out. Ceftriaxone impairs the bonds that hold the bacterial cell wall together. This allows holes to appear in the cell walls and kills the bacteria.

Ceftriaxone is a broad-spectrum antibiotic that kills a wide variety of bacteria. Ceftriaxone is given by injection to treat serious infections of the upper and lower airways, blood, skin and soft tissue. It may also be used to treat meningitis and to prevent it in contacts of people with meningitis.

To make sure the bacteria causing an infection are susceptible to ceftriaxone your doctor may take a tissue sample, for example a swab from the throat or skin, or a urine or blood sample.

What is it used for?

• Pneumonia.
• Bacterial infection of the blood (septicaemia or blood poisoning).
• Bacterial meningitis.
• Bacterial infections of the skin or soft tissue, such as boils, abscesses, cellulitis.
• Bacterial infections in people who have a low white blood cell count (neutropenia).
• Gonorrhoea.
• Preventing infection following surgery.
• Prevention of meningococcal meningitis and Haemophilus influenzae type b disease in contacts of people with these diseases (unlicensed uses).

How is this treatment given?

• Rocephin injection is usually given by injection or infusion (drip) into a vein (intravenously). It can also be given deep into a muscle such as the upper buttock or thigh.
• The dose of this medicine and how long it needs to be given for depends on the type and severity of infection you have, your age, weight, kidney and liver function.

Warning!

• Broad-spectrum antibiotics can sometimes cause inflammation of the bowel (colitis). For this reason, if you get diarrhoea that becomes severe or persistent or contains blood or mucus, either during or after treatment with this medicine, you should consult your doctor immediately.
• If you have any problems with your kidneys your doctor may want to monitor your kidney function while you are having treatment with this medicine.
• If you need prolonged treatment with this medicine your doctor may want to take regular blood tests to monitor the level of blood cells in your blood.

Use with caution in

• Severely decreased kidney function.
• People with decreased liver function together with severely decreased kidney function.
• Allergy to penicillin-type antibiotics.
• People on a controlled sodium diet (the injection contains sodium).

Not to be used in

• People who are allergic to other cephalosporin-type antibiotics.
• People with a history of an immediate severe allergic reaction to a penicillin-type antibiotic.
• Premature babies aged less than 41 weeks in total (weeks in the womb plus weeks since birth).
• Full-term newborn babies aged less than one month with high levels of bilirubin in their blood (hyperbilirubinaemia).
• Full-term newborn babies aged less than one month with jaundice or low levels of albumin in their blood.
• Full-term newborn babies aged less than one month who need intravenous calcium treatment or calcium containing drips.

This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

• This medicine is not known to be harmful when used by pregnant women. However, as with all medicines, it should be used with caution during pregnancy and only when considered essential by your doctor, particularly during the first trimester. Seek medical advice from your doctor.
• The medicine passes into breast milk in small amounts, but at normal doses this is unlikely to have any harmful effect on a nursing infant. Seek further advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Prolonged treatment with antibiotics can sometimes cause overgrowth of other organisms that are not susceptible to the antibiotic, for example fungi or yeasts such as Candida. This may sometimes cause infections such as thrush. Tell your doctor if you think you have developed a new infection during or after having treatment with this antibiotic.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

In the past, women using hormonal contraception such as the pill or patch would be advised to use an extra method of contraception (eg condoms) while having treatment with an antibiotic like this one and for seven days after finishing the course. However, this advice has now changed. You no longer need to use an extra method of contraception with the pill, patch or vaginal ring while you have a course of antibiotics. This change in advice comes because to date there is no evidence to prove that antibiotics (other than rifampicin or rifabutin) affect these contraceptives. This is the latest guidance from the Faculty of Sexual & Reproductive Healthcare.

However, if you are taking the contraceptive pill and experience vomiting or diarrhoea as a result of treatment with this antibiotic, you should follow the instructions for vomiting and diarrhoea described in the leaflet provided with your pills.

Broad spectrum antibiotics such as ceftriaxone may enhance the effect of anticoagulant medicines to prevent blood clots, such as warfarin. If you are taking warfarin your doctor may want you to have your blood clotting time (INR) checked more frequently while taking this antibiotic.

Oral typhoid vaccine (Vivotif) should not be taken until at least three days after finishing treatment with this antibiotic, because the antibiotic could make this vaccine less effective.

Probenecid may increase the blood level of ceftriaxone.

Other medicines containing the same active ingredient

Ceftriaxone injection is also available without a brand name, ie as the generic medicine.