Why is ceftriaxone avoided in neonates?
Hyperbilirubinemia is an important contraindication to administration of ceftriaxone in neonates, especially preterm newborns, because of the displacement of bilirubin from albumin-binding sites and an increase in serum concentrations of free bilirubin.
How does ceftriaxone cause hyperbilirubinemia?
Ceftriaxone caused a decrease of unconjugated bilirubin and simultaneously an increase of erythrocyte-bound bilirubin. These variations were proportionally more important for low concentrations of antibiotic, including therapeutic values.
How does ceftriaxone cause jaundice in neonates?
Cefotaxime is recommended over ceftriaxone because ceftriaxone may cause bilirubin displacement, potentially leading to serious adverse events associated with unconjugated hyperbilirubinemia such as kernicterus.
Is ceftriaxone safe in jaundice?
Ceftriaxone (applies to ceftriaxone) hyperbilirubinemia Studies have shown that ceftriaxone can displace bilirubin from its binding to serum albumin, leading to possible risk of bilirubin encephalopathy in these patients.
When do you give ceftriaxone to a neonate?
Ceftriaxone is used mostly in hospital practice for neonatal sepsis, meningitis and ophthalmia neonatorum. Its broad spectrum of activity, once daily dosing and good penetration into CSF are features favouring its use.
Why is cefotaxime used in neonates?
Cefotaxime is used instead of ceftriaxone for gram-negative septicaemia in neonates because ceftriaxone can displace bilirubin.
When does kernicterus occur?
In most cases, the syndrome characteristic of kernicterus develops by three to four years of age.
What complication is associated with ceftriaxone Rocephin administration in neonates?
Ceftriaxone – safety in neonates It can precipitate if used together with calcium leading to severe reactions including neonatal death. Other possible adverse events of significance in the neonate include biliary sludging, kernicterus and increased chances of invasive candidiasis.
Is cefotaxime a beta lactam?
Cefotaxime (CTX) is a beta-lactam antibiotic classified as a third-generation cephalosporin.
What is the contraindication of ceftriaxone?
Ceftriaxone Contraindications: Hyperbilirubinemic or premature neonates. Concomitant calcium-containing IV solutions or products in neonates. Ceftriaxone solutions containing lidocaine for IV administration.
Can we give ceftriaxone in neonates?
According to AFSSAPS, ceftriaxone is contraindicated in premature infants up to 41 wks (GA at delivery + wks after birth) of age. The FDA approved label and AFSSAPS state that it is contraindicated in neonates less than 28 days, if they receive calcium containing preparations or if there is hyperbilirubinemia.
How is cefotaxime administered?
Cefotaxime may be administered intravenously by bolus injection or by infusion, or by intramuscular injection. The dosage, route and frequency of administration should be determined by the severity of infection, the sensitivity of causative organisms and condition of the patient.
Does ceftriaxone interfere with albumin in newborns?
Kernicterus: The label warns of possible kernicterus since it can displace bilirubin from albumin. Significant bilirubin-albumin- ceftriaxone competitive interaction was observed in 14 non-jaundiced newborns aged 33-42 weeks of gestation, during the first few days of life. It is therefore not recommended in neonates with hyperbilirubinemia.
Is ceceftriaxone safe to give to a premature baby?
ceftriaxone is contra indicated in premature infants till 41 weeks of age (GA at delivery + wks after birth) and in term neonates less than 28 days if there is hyper bilirubinemia or if receiving calcium. BNF C recommends caution in preterm neonates and states it is contra indicated in
How often do you give cefoxitin to newborns?
Young and Mangum9suggested administering 25 to 33 mg/kg cefoxitin every 8 to 12 h according to the neonate’s postmenstrual age and postnatal age. When the post-menstrual age is >45 weeks, the interval between doses should be six hours. Cefuroxime
What is the VD of cephalosporin in neonates?
Abstract. The neonate’s substantial body water content creates a large volume of distribution (Vd) of cephalosporins, as these drugs are fairly water soluble. Postnatal development is an important factor in the maturation of the neonate, and as postnatal age proceeds, the clearance of cephalosporins increases.