#57 – Dosing Consult: Ceftriaxone

Breakpoints - A podcast by Society of Infectious Diseases Pharmacists - Fridays

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Drs. Tom Dilworth and Stephanie Shealy May (@stephshealymay) join Dr. Rachel Britt (@RachelBPharmD) in the first episode of Breakpoints Dosing Consults to discuss questions and debates around ceftriaxone dosing. When should we use 1g over 2g? How does critical illness affect what dose to use? Is ceftriaxone the most approachable antibiotic? Tune in for answers to these questions and more!   Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ References Ettestad PJ, Campbell GL, Welbel SF, Genese CA, Spitalny KC, Marchetti CM, Dennis DT. Biliary complications in the treatment of unsubstantiated Lyme disease. J Infect Dis. 1995 Feb;171(2):356-61. doi: 10.1093/infdis/171.2.356. PMID: 7844372. Hasegawa S, Sada R, Yaegashi M, Morimoto K, Mori T; Adult Pneumonia Study Group-Japan. 1g versus 2 g daily intravenous ceftriaxone in the treatment of community onset pneumonia - a propensity score analysis of data from a Japanese multicenter registry. BMC Infect Dis. 2019 Dec 26;19(1):1079. doi: 10.1186/s12879-019-4552-8. PMID: 31878894; PMCID: PMC6933656. Barber KE, Loper JT, Morrison AR, Stover KR, Wagner JL. Impact of Obesity on Ceftriaxone Efficacy. Diseases. 2020 Jul 9;8(3):27. doi: 10.3390/diseases8030027. PMID: 32660113; PMCID: PMC7563366. Herrera-Hidalgo L, de Alarcón A, López-Cortes LE, Luque-Márquez R, López-Cortes LF, Gutiérrez-Valencia A, Gil-Navarro MV. Is Once-Daily High-Dose Ceftriaxone plus Ampicillin an Alternative for Enterococcus faecalis Infective Endocarditis in Outpatient Parenteral Antibiotic Therapy Programs? Antimicrob Agents Chemother. 2020 Dec 16;65(1):e02099-20. doi: 10.1128/AAC.02099-20. 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PMID: 30011825; PMCID: PMC6165062. Ackerman A, Zook NR, Siegrist JF, Brummitt CF, Cook MM, Dilworth TJ. Comparison of Clinical Outcomes among Intensive Care Unit Patients Receiving One or Two Grams of Ceftriaxone Daily. Antimicrob Agents Chemother. 2020 May 21;64(6):e00066-20. doi: 10.1128/AAC.00066-20. PMID: 32205348; PMCID: PMC7269488. Ulldemolins M, Roberts JA, Rello J, Paterson DL, Lipman J. The effects of hypoalbuminaemia on optimizing antibacterial dosing in critically ill patients. Clin Pharmacokinet. 2011 Feb;50(2):99-110. doi: 10.2165/11539220-000000000-00000. PMID: 21142293. Dailly E, Arnould JF, Fraissinet F, Naux E, Letard de la Bouralière MA, Bouquié R, Deslandes G, Jolliet P, Le Floch R. Pharmacokinetics of ertapenem in burns patients. Int J Antimicrob Agents. 2013 Jul;42(1):48-52. doi: 10.1016/j.ijantimicag.2013.02.021. Epub 2013 Apr 8. PMID: 23578794. Pai MP. Treatment of bacterial infections in obese adult patients: how to appropriately manage antimicrobial dosage. 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Bremmer DN, Balada-Llasat JM, Goff DA, Bauer KA. Ceftriaxone Etest non-susceptible methicillin susceptible Staphylococcus aureus time-kill responses. Diagn Microbiol Infect Dis. 2017 Jun;88(2):192-194. doi: 10.1016/j.diagmicrobio.2017.02.019. Epub 2017 Mar 2. PMID: 28291629. Kosowska-Shick K, McGhee PL, Appelbaum PC. Affinity of ceftaroline and other beta-lactams for penicillin-binding proteins from Staphylococcus aureus and Streptococcus pneumoniae. Antimicrob Agents Chemother. 2010 May;54(5):1670-7. doi: 10.1128/AAC.00019-10. Epub 2010 Mar 1. PMID: 20194704; PMCID: PMC2863635. Palmer SM, Kang SL, Cappelletty DM, Rybak MJ. Bactericidal killing activities of cefepime, ceftazidime, cefotaxime, and ceftriaxone against Staphylococcus aureus and beta-lactamase-producing strains of Enterobacter aerogenes and Klebsiella pneumoniae in an in vitro infection model. Antimicrob Agents Chemother. 1995 Aug;39(8):1764-71. doi: 10.1128/AAC.39.8.1764. PMID: 7486916; PMCID: PMC162823. Craig WA. Interrelationship between pharmacokinetics and pharmacodynamics in determining dosage regimens for broad-spectrum cephalosporins. Diagn Microbiol Infect Dis. 1995 May-Jun;22(1-2):89-96. doi: 10.1016/0732-8893(95)00053-d. PMID: 7587056. Garot D, Respaud R, Lanotte P, Simon N, Mercier E, Ehrmann S, Perrotin D, Dequin PF, Le Guellec C. Population pharmacokinetics of ceftriaxone in critically ill septic patients: a reappraisal. Br J Clin Pharmacol. 2011 Nov;72(5):758-67. doi: 10.1111/j.1365-2125.2011.04005.x. PMID: 21545483; PMCID: PMC3243010. Joynt GM, Lipman J, Gomersall CD, Young RJ, Wong EL, Gin T. The pharmacokinetics of once-daily dosing of ceftriaxone in critically ill patients. J Antimicrob Chemother. 2001 Apr;47(4):421-9. doi: 10.1093/jac/47.4.421. PMID: 11266414. Van Wart SA et al., ICAAC 2009, poster # A1-010 Housman ST, Sutherland CA, Nicolau DP. Pharmacodynamic profile of commonly utilised parenteral therapies against meticillin-susceptible and meticillin-resistant Staphylococcus aureus collected from US hospitals. Int J Antimicrob Agents. 2014 Sep;44(3):235-41. doi: 10.1016/j.ijantimicag.2014.05.012. Epub 2014 Jun 24. PMID: 25052866. Zelenitsky SA, Beahm NP, Iacovides H, Ariano RE, Zhanel G. Limitations of ceftriaxone compared with cefazolin against MSSA: an integrated pharmacodynamic analysis. J Antimicrob Chemother. 2018 Jul 1;73(7):1888-1894. doi: 10.1093/jac/dky120. PMID: 29635472. Paul M, Zemer-Wassercug N, Talker O, Lishtzinsky Y, Lev B, Samra Z, Leibovici L, Bishara J. Are all beta-lactams similarly effective in the treatment of methicillin-sensitive Staphylococcus aureus bacteraemia? Clin Microbiol Infect. 2011 Oct;17(10):1581-6. doi: 10.1111/j.1469-0691.2010.03425.x. Epub 2010 Dec 14. PMID: 21073629. Carr DR, Stiefel U, Bonomo RA, Burant CJ, Sims SV. A Comparison of Cefazolin Versus Ceftriaxone for the Treatment of Methicillin-Susceptible Staphylococcus aureus Bacteremia in a Tertiary Care VA Medical Center. Open Forum Infect Dis. 2018 May 18;5(5):ofy089. doi: 10.1093/ofid/ofy089. PMID: 30568987; PMCID: PMC5961173. Check out our podcast host, Pinecast. Start your own podcast for free with no credit card required. If you decide to upgrade, use coupon code r-7e7a98 for 40% off for 4 months, and support Breakpoints.

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