Ceftriaxone
antibiotic · cephalosporin
Third-party optionBy the Layer Nutrition editorial team · How the atlas classifies the 664 molecules
What this medicine is for
Pharmacologically, Ceftriaxone relates to the category “antibiotic (cephalosporin)”. Antibiotics treat infections caused by bacteria. They are taken as a course, over a set duration, until the end of the prescription.
In the case of Ceftriaxone, this means: Treats a bacterial infection. It is used rather occasionally or as a short course, to get through an episode.
Under which brands it is found
Ceftriaxone is part of about 17 presentations listed in France. It is available under various trade names and as generics.
- Ceftriaxone Almus
- Ceftriaxone Arrow
- Ceftriaxone Biogaran
- Ceftriaxone Cristers
- Ceftriaxone Eg
- Ceftriaxone Evolugen
- Ceftriaxone Panpharma
- Ceftriaxone Qilu
- and other presentations
Original brand-name products and generics deliver the same active substance; the choice between them is made with your doctor or pharmacist.
On the plate: vitamin K
With ceftriaxone, as with other broad-spectrum antibiotics, the gut flora that produces part of the body's vitamin K can be disrupted, and clotting time is sometimes altered. Food provides the other major source of this vitamin, easy to find every day on the plate.
Vitamin K is concentrated in leafy green vegetables: kale and spinach lead the way, followed by broccoli and cabbages. By far, these are the foods that supply the most for a given serving.
Fish, liver, meat and eggs provide more modest amounts, useful as a complement. Varying these foods supports the body's reserves, alongside your treatment.
How ceftriaxone works
Ceftriaxone is a bactericidal antibiotic: it kills the bacterium rather than merely slowing its growth. It belongs to the family of third-generation cephalosporins. Its action targets the bacterial wall, the rigid envelope that holds the cell's shape and protects it from bursting. By disrupting the construction of this wall, the antibiotic weakens the bacterium until it lyses.
In detail, ceftriaxone binds to the penicillin-binding proteins (PBPs), enzymes known as transpeptidases. It mimics their natural substrate, the D-alanyl-D-alanine motif, and thereby blocks the cross-linking of peptidoglycan, the mesh that gives the wall its strength. Deprived of this weave, the bacterium can no longer withstand its internal pressure and ruptures.
Antibiotic therapy by injection
Ceftriaxone is given only by injection, intravenously or intramuscularly: there is no oral form. Food therefore does not affect its absorption, unlike many antibiotics taken as tablets. In healthy adults, its elimination half-life ranges on average from 5.8 to 8.7 hours, which allows a single administration per day.
In the blood, it circulates highly bound to plasma proteins: about 95 % at low concentrations, below 25 mcg/mL, and 85 % at high concentrations, around 300 mcg/mL. The body eliminates it by two routes: 33 % to 67 % of the dose leaves unchanged in the urine, and the rest passes into the bile before ending up in the stool.
How the treatment unfolds
Because it exists only in injectable form, ceftriaxone is most often administered by a healthcare professional, in hospital or at home. Its long half-life generally allows one injection per day, at a regular time. This regularity maintains a concentration effective against the bacterium throughout the treatment.
The length of the course is set by the doctor according to the infection. It must be carried through to the end, even if symptoms improve beforehand: stopping too soon leaves the least sensitive bacteria alive and encourages both relapses and resistance. Any decision to stop or change treatment rests with the prescriber.
The effects to know about
The most frequent adverse effects, reported in more than 2 % of patients, are diarrhoea, eosinophilia (a rise in a type of white blood cell), thrombocytosis (a rise in platelets), leukopenia (a drop in white blood cells) and elevation of the liver transaminases SGOT and SGPT. Several of these effects are detected through a blood test rather than by how the patient feels.
Trials provide figures for these frequencies: eosinophilia about 6 %, thrombocytosis about 5.1 %, elevated liver enzymes about 3.1 to 3.3 %, diarrhoea about 2.7 %, leukopenia about 2.1 % and skin rash about 1.7 %. These values indicate the order of magnitude of each effect, to be monitored during treatment.
Diarrhoea, gut flora and the biliary tract
Like most antibiotics, ceftriaxone can cause diarrhoea linked to the bacterium Clostridioides difficile, ranging in severity from mild forms to a colitis that can be fatal. This disorder stems from the imbalance of the gut flora that the antibiotic brings about. A Cochrane review assessed the value of probiotics in preventing this C. difficile diarrhoea in adults and children receiving antibiotics.
Ceftriaxone can also precipitate in the gallbladder as biliary sludge, a ceftriaxone-calcium salt visible on ultrasound; this pseudolithiasis is most often transient and disappears when treatment stops. In newborns, the risk of a ceftriaxone-calcium salt precipitating imposes a strict rule: never mix or co-administer ceftriaxone with intravenous solutions containing calcium.
Clotting and monitoring
With ceftriaxone, prothrombin time, a marker of clotting, can change. A supply of vitamin K (10 mg per week) is sometimes needed, particularly in patients who are undernourished or whose vitamin K reserves are already low. This vitamin is indeed essential for the liver's production of clotting factors II, VII, IX and X.
Vitamin K has two origins: food, and the bacteria of the intestine, which broad-spectrum antibiotics can disrupt. It is this dual effect, on the flora and on clotting, that justifies laboratory monitoring during treatment. The doctor adjusts the course of action according to the results and the nutritional status.
Sources
Related molecules
To explore in the « Anti-infectives » family and its neighbours.
See the whole « Anti-infectives » family · Back to the atlas
Supplements to consider
Beyond the plate, a single isolated nutrient can be worth discussing, to confirm with your doctor or pharmacist. Here is which one and in which form.
Probiotics
Probiotics are live micro-organisms, mainly lactobacilli and bifidobacteria. The CFU count and the number of strains are among the selection criteria; gastro-resistant capsules protect the bacteria from stomach acidity.
Preferred form gastro-resistant capsules, several strains, CFU count stated
Frequently asked questions
What are the side effects of ceftriaxone?
The package insert notably lists pain or a burning sensation at the injection site, digestive problems such as diarrhea, itchy skin rashes, and changes in certain blood test results. Sudden swelling of the face or throat calls for immediate medical attention. For the complete list, refer to the package insert and discuss any symptom with your doctor or pharmacist.
How is ceftriaxone given?
Ceftriaxone is an antibiotic in the cephalosporin family that is given by injection, either intravenously (IV) or intramuscularly (IM), under the supervision of a healthcare professional. The exact regimen is up to your doctor: follow the prescription and the package insert, and never adjust it yourself.
Does ceftriaxone interact with calcium?
Yes, ceftriaxone must not be mixed in the same infusion with intravenous solutions containing calcium, because precipitates can form. This precaution mainly concerns the intravenous route and newborns. Tell your doctor or pharmacist about all your medications and supplements, and let the package insert guide you.
Can you receive ceftriaxone during pregnancy or breastfeeding?
Use during pregnancy or breastfeeding is a case-by-case decision made by the doctor, who weighs the benefit against the risk. Always tell the healthcare professional if you are pregnant, think you may be, or are breastfeeding, and refer to the package insert.
Why can ceftriaxone cause diarrhea?
Like broad-spectrum antibiotics, ceftriaxone disrupts the balance of the gut flora, which can promote what is known as antibiotic-associated diarrhea. Heavy, prolonged, or bloody diarrhea should be reported to your doctor or pharmacist without delay.
What to take to support gut flora during antibiotic treatment?
Broad-spectrum antibiotics are associated with a drop in the diversity of the gut microbiome, and systematic reviews link certain probiotic strains to a lower risk of antibiotic-associated diarrhea. The most documented strain is the yeast Saccharomyces boulardii, often cited alongside Lactobacillus rhamnosus GG. Because it is a yeast, Saccharomyces boulardii is not targeted by antibacterial antibiotics. The form to consider is a probiotic in capsules or sachets that clearly states the strain; the use and timing should be discussed with your doctor or pharmacist.
Ces réponses portent sur le volet nutritionnel. Pour toute question sur votre médicament, la notice et votre médecin ou pharmacien font foi.