頭孢曲松
Ceftriaxone
Ceftriaxone sodium
別名: Rocephin · ceftriaxonum natricum · Ro-139904 · Ro-13-9904/000
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
經審核的 v13 劑量證據
結構化劑量計算證據Borreliosis | Lyme disease | Borrelia burgdorferi infection (extra-label)
須由已驗證獸醫確認
- q24h
NA
必須同時考慮的臨床上下文 (2)
- NOTE: In humans, it is recommended that IV infusions be administered over 30 minutes (60 minutes in neonates) at concentrations between 10 – 40 mg/mL. 9
- The sterile powder for reconstitution should be stored between 20°C to 25°C (68°F-77°F) and protected from light.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
頭孢曲松是一種強效的注射型第三代頭孢菌素抗生素。
- 廣泛的抗菌譜：保留了第一代和第二代藥物的革蘭氏陽性菌活性，並顯著擴展了對革蘭氏陰性菌（如腸桿菌科）的覆蓋範圍。
- 臨床應用：通常用於治療嚴重感染，特別是當其他較便宜的藥物無效，或為了避免氨基糖苷類藥物的腎毒性時。
- 主要優勢：能極佳地穿透中樞神經系統（CNS），非常適合治療腦膜炎。其長半衰期及對伯氏疏螺旋體（Borrelia burgdorferi）的活性，使其成為治療萊姆病的潛在選擇。
作用機制
Like all beta-lactam antibiotics, ceftriaxone is bactericidal.
- Mechanism: It binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall.
- Pathway: Binding to PBPs → Inhibition of the third and final stage of bacterial cell wall synthesis → Disruption of peptidoglycan cross-linking → Autolysin-mediated bacterial cell lysis and death.
安全性與警告
禁忌症
- Prior allergic reaction to cephalosporins
不良反應
- Pain on IM injection
- Hypersensitivity reactions (rash)
- Granulocytopenia / thrombocytopenia
- Diarrhea
- Mild azotemia
- Biliary sludging (at very high doses)
- Increased liver enzymes, BUN, and creatinine
注意事項
Important: Give IV injections slowly over at least 30 minutes to minimize adverse reactions.
- Hypersensitivity: Contraindicated in patients with known cephalosporin allergies. Use with caution in penicillin-allergic patients due to potential cross-reactivity.
- Hepatic/Coagulation Issues: Use cautiously in patients with severe hepatic disease or vitamin K synthesis abnormalities, as cephalosporins can rarely affect bleeding times.
- Renal Impairment: Dosage adjustments may be necessary in severe uremia, especially if concomitant hepatic impairment exists.
- Biliary Sludging: High doses may cause biliary sludging (pseudolithiasis), particularly noted in dogs at very high doses (100 mg/kg/day).
藥物相互作用
Potential additive nephrotoxicity; in vitro studies show synergistic or additive antibacterial activity.
Concomitant use with calcium-containing solutions has caused fatal calcium-ceftriaxone precipitates in neonates. Do not mix with calcium or administer within 48 hours of ceftriaxone.
監測
- Clinical efficacy
- CBC (with long-term therapy)
- Renal function (BUN, Serum Creatinine, urinalysis)
- Liver enzymes (AST, ALT)
藥物動力學
半衰期
吸收
Not absorbed after oral administration; must be given parenterally. In dogs, IM and SC bioavailability equals IV. Peak levels occur faster after IM (~30 minutes) than SC (~80 minutes).
分佈
Widely distributed throughout the body. CSF levels are higher when meninges are inflamed. Crosses the placenta and enters maternal milk in low concentrations.
代謝
Not extensively metabolized.
排除
Excreted by both renal and non-renal (biliary) mechanisms.
過量
Limited information is available regarding acute toxicity. Overdoses should be monitored and treated symptomatically and supportively if required.
可用產品
劑型
- Injection powder for solution
人用標示
- Ceftriaxone Injection Powder for Solution: 250 mg, 500 mg, 1 g, 2 g, & 10 g (as base) in vials, single-use duplex containers, and in bulk
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store sterile powder at or below 25°C and protect from light. Reconstituted solutions (100 mg/mL) are stable for 3 days at room temperature and 10 days refrigerated. Solutions of 250 mg/mL are stable for 24 hours at room temperature and 3 days refrigerated. Frozen solutions (10-40 mg/mL) at -20°C are stable for 26 weeks.
飼主須知
注意：頭孢曲松是一種注射型藥物，通常由獸醫專業人員在醫院內給藥。
- 注射部位疼痛：您的寵物在接受肌肉注射（IM）時可能會感到疼痛或不適。
- 腸胃不適：請留意是否有腹瀉或軟便的跡象，這是許多抗生素常見的副作用。
- 過敏反應：如果您發現過敏反應的跡象（如面部腫脹、蕁麻疹、皮疹或呼吸困難），請立即聯繫您的獸醫。
- 監測：如果您的寵物需要長期接受此藥物治療，獸醫可能會建議定期進行血液檢查，以監測肝腎功能。
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