1 May 2026Injectable drugsSource update: September 2023
Ceftriaxone injectable
Ceftriaxone guidance for severe bacterial infections and gonococcal disease, with IM and IV administration rules.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
Therapeutic action
Third-generation cephalosporin antibacterial.
Indications
- Severe bacterial infections including septicaemia, meningitis, pneumonia, typhoid fever, shigellosis, leptospirosis, relapsing fevers, pyelonephritis, and neurosyphilis.
- Cervicitis, urethritis and conjunctivitis due to Neisseria gonorrhoeae, and chancroid.
Forms and strengths, route of administration
- Powder for injection, in 250 mg or 1 g vials.
- For IM injection only, the vial may be dissolved with the solvent containing lidocaine.
- For slow IV injection or infusion, dissolve with water for injection only, then infuse in 0.9% sodium chloride or 5% glucose.
Dose and duration
The dose varies according to indication.
Duration varies according to indication and clinical response. Change to oral treatment as soon as possible.
Severe bacterial infections
- Child 1 month and over under 50 kg: 50 to 100 mg/kg, maximum 4 g, once daily.
- Child 50 kg and over and adult: 1 to 2 g once daily, up to 2 g 2 times daily or 4 g once daily for meningitis and typhoid fever.
Gonococcal cervicitis and urethritis, chancroid
- Child under 45 kg: 125 mg IM single dose.
- Child 45 kg and over and adult: 500 mg IM single dose, or 250 mg IM single dose for chancroid.
Gonococcal conjunctivitis
- Neonate: 50 mg/kg IM single dose, maximum 125 mg.
- Adult: 1 g IM single dose.
Contra-indications, adverse effects, precautions
- Once reconstituted, the solution must be used immediately.
- Do not administer to patients with allergy to cephalosporins or penicillins, and to neonates with jaundice or receiving calcium gluconate.
- Administer with caution in patients with hepatic or renal impairment. Reduce dosage in severe renal impairment.
- May cause gastrointestinal disturbances, hepatic dysfunction, blood disorders, renal dysfunction, and allergic reactions sometimes severe.
- Do not mix ceftriaxone with calcium-containing solutions such as Ringer lactate.
- Pregnancy: no contra-indication.
- Breast-feeding: no contra-indication.
- Doses greater than 1 g IM should be administered in 2 equally divided injections.
- Doses greater than 2 g should be administered by IV infusion only.
- Do not mix with another drug in the same syringe or infusion.
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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