Ceftriaxone - Info

[Advocatus Diaboli]

Since Cambodian doctors/pharmacists spread antibiotics to the public like Smarties, resistances become more common.
Ceftriaxone is a 3rd generation antibiotic and used to treat a wide variety of serious infections caused by gram positive and gram negative organisms that are resistant to most other antibiotics. It's a choice drug for treatment of bacterial meningitis, pneumonia, skin infections, bone and joint infections, gonorrhea, abdominal and urinary tract infections, pelvic inflammatory disease , and bacterial septicemia.
Ceftriaxone has to be injected intramuscular. It comes as a powder in 1000 mg vials and costs around $ 1. Don't forget to buy syringe, needle and distilled water (Riel 1000 ?)

[Anchor Moy]

Since Cambodian doctors/pharmacists spread antibiotics to the public like Smarties, resistances become more common.

If it's irresponsible for Cambodian doctors to do this, then it must be a good idea to diagnose yourself as antibiotic resistant and head straight for what might be the only stuff that will work if you have serious problems.
Did I read you right ?

[Cam Nivag]

Ceftriaxone has to be injected intramuscular.

No it doesn't. It is often administered via I.V.

[Kuroneko]

Cefixime is also a third generation cephalosporin with similar pharmacological properties to Ceftrioxone and is administered orally. This was used from the early '90's as an oral alternative to Ceftrioxone for treating uncomplicated N. gonorrhoeae. Below are a couple of studies from 1991/2

A comparison of single-dose cefixime with ceftriaxone as treatment for uncomplicated gonorrhea. The Gonorrhea Treatment Study Group.N Engl J Med. 1991 Nov 7;325(19):1337-41.

Background
Because of the widespread existence of Neisseria gonorrhoeae resistant to penicillin or tetracycline, ceftriaxone is now recommended for the treatment of gonorrhea. There is, however, a need for effective antibiotics that can be administered orally as an alternative to ceftriaxone, which requires intramuscular administration. Cefixime is an orally absorbed cephalosporin that is active against resistant gonococci and has pharmacokinetic activity suitable for single-dose administration.

Conclusions
In the treatment of uncomplicated gonorrhea, a single dose of cefixime (400 or 800 mg) given orally appears to be as effective as the currently recommended regimen of ceftriaxone (250 mg given intramuscularly).
http://www.ncbi.nlm.nih.gov/pubmed/1922235

Oral cefixime versus intramuscular ceftriaxone in patients with uncomplicated gonococcal infections. Sex Transm Dis. 1992 Mar-Apr;19(2):94-8.

A randomized trial was conducted to compare cefixime (400 mg or 800 mg single oral dose) with ceftriaxone (250 mg single intramuscular dose) in terms of efficacy and safety for the treatment of uncomplicated Neisseria gonorrhoeae urethritis or cervicitis.
Cefixime was as well tolerated and efficacious as ceftriaxone in the treatment of the patients with uncomplicated N. gonorrhoeae urethritis or cervicitis reported here.http://www.ncbi.nlm.nih.gov/pubmed/1534422

Note current recommendations from CDC
For treatment of uncomplicated urogenital, anorectal, and pharyngeal gonorrhea, CDC recommends combination therapy with a single intramuscular dose of ceftriaxone 250 mg plus either a single dose of azithromycin 1 g orally or doxycycline 100 mg orally twice daily for 7 days (Box). http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a3.htm

[TheGrinchSR]

Since Cambodian doctors/pharmacists spread antibiotics to the public like Smarties, resistances become more common.

If it's irresponsible for Cambodian doctors to do this, then it must be a good idea to diagnose yourself as antibiotic resistant and head straight for what might be the only stuff that will work if you have serious problems.
Did I read you right ?

100% correct. Following this advice will destroy one of the last set of effective anti-biotic measures available. And while new antibiotics have been tentatively discovered... if they don't work - in 20 years time people are going to be dropping flies dying from the most basic of illnesses and even a tiny cut could kill you. Nice going OP.

[Cam Nivag]

IV ceftriaxone (Rocephin) is for really serious bacterial infections and people shouldn't be self-diagnosing and administering it. I also wouldn't inject any IV antibiotics into me that cost a dollar.

I was on a course of IV Rocephin for a month back in 2012.

[Kuroneko]

Since Cambodian doctors/pharmacists spread antibiotics to the public like Smarties, resistances become more common.
Ceftriaxone is a 3rd generation antibiotic and used to treat a wide variety of serious infections caused by gram positive and gram negative organisms that are resistant to most other antibiotics. It's a choice drug for treatment of bacterial meningitis, pneumonia, skin infections, bone and joint infections, gonorrhea, abdominal and urinary tract infections, pelvic inflammatory disease , and bacterial septicemia.

Not quite sure what you're getting at here. You mention antibiotic resistance and then seem to be recommending an old but admittedly well tried drug whose over use has lead to the development of many antibiotic resistant strains of bacteria, and may not always be effective in many cases. It is important to get ones pathology right before deciding on the appropriate antibiotic. For example you mention ceftrioxone as the drug of choice for bacterial menigitis when in some instances vancomycin may be more appropriate. Admittedly this is not clear cut, see the review Management of Infections Due to Antibiotic-Resistant Streptococcus pneumoniaeClin Microbiol Rev. 1998 Oct; 11(4): 628–644.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC88901/


Note this article from as far back as 1998: Antibiotic-resistant strains of Streptococcus pneumoniae are becoming more prevalent throughout the world; this has resulted in modifications of treatment approaches. Management of bacterial meningitis has the greatest consensus. Strategies for treating other systemic infections such as pneumonia, bacteremia, and musculoskeletal infections are evolving, in part related to the availability of new antibiotics which are active in vitro against isolates resistant to penicillin and the extended-spectrum cephalosporins.

However, by the early 1990s, as penicillin-resistant pneumococcal isolates became more common throughout the world, treatment failures associated with cefotaxime or ceftriaxone administration for pneumococcal meningitis were reported
Management of Infections Due to Antibiotic-Resistant Streptococcus pneumoniaeClin Microbiol Rev. 1998 Oct; 11(4): 628–644. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC88901/

Meningitis Due to Ceftriaxone-Resistant Streptococcus pneumoniae N Engl J Med 1995; 332:893-894 http://www.nejm.org/doi/full/10.1056/NE ... 3303321317

While Ceftrioxone is still in some instances an effective drug it is also a very old drug that was introduced into clinical practice in the USA in 1985. A study conducted between 1996 and 2000 notes "ceftriaxone has retained its potent activity against the most commonly encountered Gram-positive and Gram-negative human pathogens despite widespread and ongoing clinical use for more than 15 years."Int J Antimicrob Agents. 2002 May;19(5):413-26)http://www.ncbi.nlm.nih.gov/pubmed/12007850, however there was also evidence of increasing resistance, for example Emergence of domestically acquired ceftriaxone-resistant Salmonella infections associated with AmpC beta-lactamase. (JAMA. 2000 Dec 27;284(24):3151-6.) http://www.ncbi.nlm.nih.gov/pubmed/11135779 Increasing Ceftriaxone Resistance and Multiple Alterations of Penicillin-Binding Proteins among Penicillin-Resistant Streptococcus pneumoniae Isolates in Taiwan (Antimicrob Agents Chemother. 2007 Sep; 51(9): 3404–3406.) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2043203/ As a result of resistance to 3rd generation cephlosporins from 1993 onward, cephalosporins of the 4th generation were developed, for example: cefepime and cefpirome.

Ironically the effectiveness of ceftrioxone has lead to its overuse and decreased effectiveness. S.J. Dancer notes: "Although widely accepted as broad-spectrum antibiotics, cephalosporins are not active against all the bacteria commonly isolated in a hospital microbiology laboratory. Organisms that are not inhibited by cephalosporin therapy consequently overgrow, with varying potential to cause infection. Some of these are instantly recognizable as pathogens; others, although originally regarded as commensal or of low risk status, have subsequently been shown to cause disease. Furthermore, there is an association between cephalosporin usage and the emergence of multiply-resistant organisms." The problem with cephalosporins Journal of Antimicrobial Chemotherapy Volume 48, Issue 4 Pp. 463-478 http://jac.oxfordjournals.org/content/48/4/463.full

To combat such resistant infections 5th generation cephalosporins such as ceftaroline , and ceftobiprole appeared in the mid 2000's. For example: Ceftaroline a New Cephalosporin with Activity against Methicillin-Resistant Staphylococcus aureus (MRSA) Clin Med Rev Ther. Author manuscript; available in PMC 2012 Feb 10.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140339/

The effect of this heavy usage of cephalasporins is well summed up by S. J. Dancer in the previously cited article:
In conclusion, the selection pressure created by heavy usage of cephalosporin antibiotics over the last 20 years has generated a plethora of multiply-resistant organisms. The possible links between C. difficile, VRE and MRSA serve as a warning for potentially untreatable infection—with ESBLC providing the Gram-negative equivalent. The risks posed by overuse of cephalosporins remain only speculative, unless specific proof is forthcoming. By then, though, we may be contemplating the post-antibiotic era.

[Advocatus Diaboli]

Yes people, everything you have mentioned here is correct, and indeed in 20 or 30 years from now on there will be no efficient antibiotic anymore (and then the dying begins again).
Shortly after the first sulfonamide was commercially available in 1932 an arms race between microorganisms and antibiotics began. From that 7 billion people on Earth an estimated 5 billion take antibiotics uncontrolled.
Now you can play hardliner, and say “No, no antibiotics – ever” ……nature will appreciate and kill you, so please feel free to sacrifice yourself. I personally would have died many times already without antibiotics, and esp. in a country like Cambodia (or any other 3rd world country) with inadequate medical facilities and doctors and not much money available it’s good to know an antibiotics that not everybody takes, that still helps and that is inexpensive. It could save your life (for now).

I also find it a bit strange and hypocritical if a bunch of underpaid guys that put their dicks in every possible cavity, consuming all kind of illegal drugs suddenly feel blue and complain about antibiotics !!!

[frank lee bent]

ha! i do NONE of the above!
however i am not certain about the underpaid part.
probably fits as i do not have enough money.

[Advocatus Diaboli]

Make a test. Get sick and go to the SOS clinic in Phnom Penh. If you can pay the bill you do have enough money.