Rocephin®

Ceftriaxone

Introduction

Rocephin® is the trade name for a drug containing the active ingredient ceftriaxone, which is an antibiotic. Antibiotics can be divided into different groups, whereby ceftriaxone belongs to the group of cephalosporins and is counted in the 3rd generation. Antibiotics are generally used to kill or inhibit the growth of bacteria, i.e. they are used to combat bacterial infections such as pneumonia (pneuomonias), urinary tract infections and many others.

Each group of antibiotics has a particularly good effect on certain bacteria and a less good effect on others. Ceftriaxone is one of the broad-spectrum antibiotics, so it has a good effect against many germs. Ceftriaxone can only be used parenterally, i.e.

bypassing the gastrointestinal tract, i.e. it cannot be administered as a tablet but only as an infusion via the vein (intravenous = i.v.) or as an injection into the muscle (intramuscular = i.m. ).

Side effects

All cephalosporins, including ceftriaxone, can cause allergic reactions. Primarily they show themselves on the skin through different types of rash (exanthema). Also an anaphylactic reaction up to anaphylactic shock is possible, this is life-threatening.

This is a severe overreaction of the immune system, which is divided into several stages. In the beginning, skin reactions such as rashes and wheals can appear, in the course of the disease there is a feeling of heat, difficulty swallowing and breathing (bronchospasm), nausea, vomiting and diarrhoea, in the actual shock there is a significant drop in blood pressure (hypotension) with a sharp increase in heart rate (tachycardia) due to dilation of the vessels, which can even lead to unconsciousness. The anaphylactic reaction usually occurs – in contrast to the allergy – within a few minutes after application of the drug.

The allergy, on the other hand, can also appear days to weeks after the initial administration and develops rather insidiously. Furthermore, reversible changes in the blood count and an increase in liver values can occur with the application of Ceftriaxon, but these usually do not cause any further symptoms and are only conspicuous in the laboratory values. Since Ceftriaxone can only be administered intravenously, it has fewer gastrointestinal side effects (nausea, vomiting, abdominal pain, diarrhea) than other drugs in its group.

Inflammation of the vein (thrombophlebitis) may occur during intravenous administration. At higher doses, kidney damage may occur. In 5-10% of cases there is a so-called cross-allergy to the penicillins.

This means that if a patient cannot tolerate an antibiotic from the group of penicillins and one has to switch to another drug, this allergy can also occur under the administration of Ceftriaxone, with a probability of 5-10%. Further possible side effects of Rocephin® are chills, headaches and fungal infections in the mouth and pubic area by killing the protective germ flora. Also antibiotics from the group of Cephalosporins can be triggers of a so-called pseudomembranous Enterocolitis, an inflammation of the intestine.

It is caused by the fact that the antibiotics inhibit or kill the resident (i.e. normally present) germ flora of the intestine, thus leaving room for the population with the bacterium Clostridium difficile. This disease manifests itself, among other things, through abdominal pain, diarrhea and fever. If such colitis is diagnosed, the antibiotic must be discontinued and replaced by another that is effective against the said germs (metronidazole or vancomycin).

In rare cases, cephalosporins can cause anemia. Ceftriaxone and also all other antibiotics from the group of cephalosporins should not be combined with antibiotics from the group of aminoglycosides (e.g. gentamycin), as this significantly increases the risk of kidney damage. A combination with water tablets from the group of loop diuretics (e.g. furosemide (Lasix®) should also be avoided for this reason.

Also a combination with antibiotics from the group of tetracyclines and chloramphenicol should not be taken, as they inhibit each other in their effectiveness. The efficacy of oral contraceptives such as the pill can be reduced by taking antibiotics, so an additional method of contraception is advisable during the period of antibiotic use.Furthermore, cephalosporins often lead to a wrong determination of the urine sugar in the context of diabetes diagnostics, therefore the doctor must be informed beforehand about the intake of Ceftriaxone. The administration of Ceftriaxone at the same time as calcium-containing infusion solutions must be avoided at all costs, as this can lead to the formation of crystals with deposits in the lungs and kidneys.