頭孢曲松
**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.
各物種劑量
- Systemic infections · 25-50 mg/kg IV , IM or Intraosseous q12h as long as necessary · IV/IM/Intraosseous · q12h · As long as necessary
- Susceptible infections · 25-50 mg/kg q12h IV or IM · IV/IM · q12h · Excellent CSF and bone penetration; expensive.
- Susceptible infections · 20 mg/kg IV q12h · IV · q12h
- Meningitis/borreliosis · 15-50 mg/kg (maximum single dose in humans is 1 gram) IV or IM q12h for 4-14 days · IV/IM · q12h · 4-14 days
- Preoperative/intraoperative use · 25 mg/kg (maximum single dose in humans is 1 gram) IM or IV one time · IM/IV · once · 1 dose
- Skin, genitourinary infections · 25 mg/kg IM once daily (q24h) for 7-14 days · IM · q24h · 7-14 days
- Infectious endocarditis and documented resistance against or other contraindications for fluoroquinolones and aminoglycosides · 20 mg/kg IV q12h · IV · q12h
- General susceptible infections · 15-50 mg/kg (route not specified) once daily · Not specified · q24h
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
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
藥物相互作用
- Aminoglycosides / Nephrotoxic drugs · Potential additive nephrotoxicity; in vitro studies show synergistic or additive antibacterial activity.
- Calcium · 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)
過量
Limited information is available regarding acute toxicity. Overdoses should be monitored and treated symptomatically and supportively if required.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。