April 18th, 2009

Ceftriaxone and Calcium — OK Again in Adults!

As every house officer, hospitalist, intensivist, and ID doc knows, ceftriaxone and calcium have been contraindicated since 2007 due to fears of a potentially fatal precipitation of the two that led to the death of 5 neonates.

Pediatricians are fond of saying “kids are not small adults” (I should know), and if that’s true, it’s even more so that “neonates are not really really tiny adults.”

So it’s not surprising that follow-up in vitro studies have shown that this is unlikely to be a problem when the drugs are administered sequentially.  It’s also not surrising since no case of this fatal ceftriaxone/calcium precipitation had ever occurred in adults, even though ceftriaxone has been one of the most commonly-given antibiotics on the planet for decades.

But now we can give them to the same patient again, so long as the person is older than 28 days, and ceftriaxone and calcium are administered sequentially.


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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

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