How and with what should the antibiotic Ceftriaxone be diluted?

Dilution of antibiotic powders

• The powder in the bottle should be white.
• The powder can only be dissolved with water for injection (saline solution, glucose solution, tap water :-), etc.).
• You need to take as much solvent as possible (as little as possible).
• The diluted powder should be transparent and colorless.

You will find answers to all these questions in the instructions for the drug. The powder may be dark - this may be its normal color, or it may be an indicator of unsuitability. Some antibiotics release gas or form a cloudy solution when dissolved. The powder should be dissolved only with the solution and volume specified in the instructions.

First of all, you need to prepare everything for the procedure, read the doctor’s prescription and instructions again, check the prescribed dosage, check whether you have purchased everything that was prescribed, note how many injections all the medications are enough for, so as not to rush to all the surrounding pharmacies at the last moment . Cover the table with a clean napkin so you can put everything you need on it. Prepare cotton wool, medical alcohol (not pure, no more than 70%), if there is no pure ethyl alcohol, you can use medical alcohol solutions - salicylic acid, chloramphenicol, furatsillin. Colognes and lotions are not recommended.

Remove the foil from the bottles so as to open the middle of the rubber stopper. If the solvent is in ampoules, then prepare a cutter for ampoules - such a cutter is included in each box of ampoules. Prepare a disposable syringe - remove the packaging from it, but it is advisable not to remove the cap from the needle. It is better to use 2 syringes: one for injection - the smallest permissible volume (equal to the volume of the required solvent). That is, if you dilute the powder with 2 ml of solvent, you should not take a 10 ml syringe. The fact is that usually smaller volume syringes have thinner needles. It is better to take the second syringe 5-10 ml, they have thicker needles, with their help you can prepare a powder solution much easier and faster, and the sterility of the solution will be higher.

Wash your hands with soap and wipe with an alcohol solution. Then wipe the ampoules and rubber stoppers of the bottles with alcohol. Open the required ampoules.

Which solvent should I choose?

In most cases, the doctor will tell you which solvent to use. If for some reason he did not do this and there is no way to clarify further, what should he do?

Consult a pharmacist at the pharmacy, read the instructions for the drug. Remember the peculiarities of diluting the drug - for example, gas bubbles are released, the solution turns a certain color, and a suspension is formed.

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Use of Ceftriaxone for pneumonia in adults

Ceftriaxone is indicated for the treatment of pneumonia in adults that meets the following criteria:

• clear consciousness;
• sweating, general weakness, but the patient can move independently;
• temperature up to 39 degrees;
• pressure is reduced, but does not fall below 90 mm Hg. Art.;
• pulse up to 100 beats per minute;
• respiratory rate up to 30 per minute at rest;
• chest x-ray shows a focus of inflammation;
• there are no signs of complications (severe cardiac, respiratory failure, damage to the membranes of the brain, kidneys).

How many days to inject

Most often (standard course of treatment) Ceftriaxone for pneumonia needs to be injected for 5-7 days, it is administered 1-2 g per day once. In hospital settings, 2 droppers with the drug are usually prescribed (once a day), then switch to intramuscular injections every 24 hours. If the doctor allows home treatment, then from the first day the injections are given into the gluteal muscle.

When does it take effect?

Ceftriaxone begins to act within 2-3 hours. At this time, its maximum concentration is created in the blood, and it penetrates into the tissues, including the lungs. When 1-2 g of the drug is administered, a sufficient amount of medication is contained at the site of inflammation and persists throughout the day. The first clinical manifestations of the effect of the antibiotic are observed from 2-3 days.

We recommend reading about how to use Ceftriaxone for sinusitis. From the article you will learn why Ceftriaxone is prescribed for sinusitis, sinusitis and other ENT diseases, as well as how to properly inject the antibiotic and what to do if it does not help.

On what day does the temperature begin to subside?

After starting treatment with Ceftriaxone, a drop in temperature is observed in almost 80% of patients by day 3. Some of them show positive dynamics already on the second day. The healing process will take a little longer:

• with broncho-obstructive syndrome (bronchial spasm with impaired sputum excretion);
• in bedridden and elderly patients suffering from chronic inflammatory diseases of the bronchopulmonary system;
• against the background of pneumosclerosis (hardening of the lungs) or bronchiectasis (irreversible dilatation of the bronchi).

The effectiveness of the drug is assessed on days 3-5; this requires a mandatory medical examination, since it is important to check the condition of the lungs, the presence of wheezing, and residual signs of intoxication. If necessary, the therapist recommends continuing the administration of Ceftriaxone or canceling it, supplementing it with another drug, or completely changing the antibiotic.

Basic rules for treatment with Ceftriaxone

To effectively treat pneumonia, adhere to the following rules for prescribing the drug:

• application begins even before sputum culture, immediately after confirmation of the diagnosis;
• the dose depends on the extent of inflammation, signs of intoxication (fever, muscle and general weakness, headache);
• after identification (detection) of the pathogen, its sensitivity to Ceftriaxone is determined, the course of treatment depends on this, dose prescriptions are adjusted and the need for a second drug is determined;
• You cannot independently interrupt the administration of the drug or extend the interval between its administration (more than a day).

You can discontinue the drug after:

• at least 5 days have passed;
• temperature up to 36.8 lasts for 2 or more days;
• no shortness of breath;
• decreased cough and chest pain;
• there are positive changes in blood tests.

The doctor monitors the effectiveness of treatment

Is it possible to use in pregnant and lactating women with pneumonia?

Ceftriaxone, in the treatment of pneumonia, crosses the placenta from the pregnant woman to the fetus; it is also found in breast milk during feeding. Therefore, antibiotics are prescribed to women during these periods only for very strict indications. A doctor can only recommend a medication if the benefit to the mother's health outweighs the risk to the baby.

In the first trimester of pregnancy, it is especially important to be careful, since there is no confirmed data on safety, lack of influence on the development of the fetus and the formation of internal organs. There are only reports of animal studies in which no complications were found. Self-administration of the drug is strictly prohibited.

Rules for diluting antibiotics and drawing the drug from a bottle

Target:

parenteral administration of drugs.

Indications:

doctor's prescription.

Contraindications:

expired shelf life of the drug, violation of the sterility of the bottle.

Equipment:

a bottle of medicine, a syringe with a needle; 70% alcohol, cotton balls, scissors.

Rules for diluting antibiotics:

Solvents: 0.25% or 0.5% novocaine solution, 0.9% sodium chloride solution, sterile water for injection.

The most popular antibiotic is penicillin (benzylpenicillin sodium or potassium salt). It is available in bottles of 250,000, 500,000, 1,000,000 units. Dosed in action units.

1 ml of solution should contain 100,000 units of penicillin

Thus, if the bottle contains 500,000 units, then you need to take 5 ml of novocaine.

Algorithm of actions of the nurse:

1. Read the name of the medicine, its dosage, and expiration date on the bottle.

2. Bend the metal cap with tweezers and treat the rubber stopper with alcohol.

3. Fill the syringe with the required amount of solvent, pierce the stopper with a large-diameter needle and inject the solvent into the bottle.

4. Remove the bottle along with the needle from the needle cone and, shaking the bottle, ensure that the powder is completely dissolved.

5. Place the needle on the needle cone.

4. Turn the bottle upside down, pull the plunger towards you - the medicine flows into the syringe.

5. Having collected the required amount of the drug, remove the needle from the bottle.

Note.

Opened bottles must be used within 24 hours.

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When is it prescribed to inject Ceftriaxone intramuscularly?

Intramuscular administration of Ceftriaxone is the most popular route of administration of this antibiotic and is prescribed for moderate to severe infections.

Indications for injections:

• blood poisoning - sepsis;
• inflammation of the membranes of the brain - meningitis;
• infections inside the abdominal cavity and pelvis - peritonitis, suppuration of the gallbladder and ducts (cholecystitis, cholangitis), endometritis, adnexitis, prostatitis;
• inflammatory process in bones and joints, soft tissues, skin - osteomyelitis, purulent arthritis, abscess (abscess), phlegmon (suppuration of soft tissues), carbuncle;
• bacterial meningitis;
• infectious inflammation of the kidneys and urinary tract – pyelitis, pyelonephritis, urethritis;
• diseases of the ENT organs - sore throat, otitis, sinusitis with the risk of complications;
• infected wounds and burns;
• inflammation of the respiratory tract - pneumonia, suppuration in the pleura, pleurisy, bronchiectasis, lung abscess;
• specific infections - syphilis, gonorrhea, tick-borne borreliosis (Lyme disease), salmonellosis, typhoid fever;
• infectious lesions in the maxillofacial area;
• prevention of suppuration during operations on the biliary, urinary tract, digestive organs and gynecology.

We recommend reading the article about how many days to inject Ceftriaxone. From it you will learn for which diseases and for how many days Ceftriaxone should be injected into children and adults, how to dilute the drug, and the interval between injections. And here is more information about how to dilute Ceftriaxone with Lidocaine.

Features of water for injection

Water for injection is a medicine that can be bought at every pharmacy. It is not used as monotherapy. Its main purpose is to dissolve drugs for their subsequent parenteral administration: intravenous, intracavitary, subcutaneous, intraarticular, intramuscular.

It is a tasteless, colorless liquid without odor or foreign inclusions. It is packaged in plastic or glass sealed ampoules with a volume of 1 to 10 ml. To open the latter, manufacturers insert special cutting metal strips into the cardboard box. The package contains 10 ampoules along with detailed instructions for use.

Water for injection is sterile, so it must be used immediately. To dissolve which dosage forms of drugs it is used:

Often, water for injection is used to dilute standard solutions for parenteral administration. In this way, the concentration of their active ingredients is reduced. Medicines in reduced doses are indicated in the elderly, senile, children and adolescents, in the presence of severe liver and kidney diseases.

Dosage of Ceftriaxone injections for coronavirus

Ceftriaxone for coronavirus is administered in a dose of 1 g twice a day intravenously in combination with Azithromycin, Clarithromycin. The doctor may choose a higher dose for extremely severe pneumonia, but it should not exceed 4 g for an adult.

Children weighing over 50 kg are prescribed the same dosages, and for those with a lower body weight, 50-70 mg are calculated per 1 kg of weight. In complicated forms of pneumonia, treatment with Ceftriaxone begins on the first day after the patient’s admission to the hospital.

Main characteristics of water for injection

The drug is produced by many domestic and foreign pharmaceutical factories. At all technological stages, it undergoes thorough purification from foreign impurities, the penetration of which into the human body leads to a deterioration in well-being. At the initial stage of production, mineral salts are removed from water by heating it. This way it softens, becomes completely chemically inert, and does not interact with the ingredients of medications.

Then it undergoes distillation - distillation, evaporation of the liquid, followed by cooling and condensation of the vapor. This helps get rid of all other impurities:

microscopic gas bubbles;

In factories producing water, all aseptic rules are observed. After purification distillation, it is packaged in primary packaging and then sterilized in industrial autoclaves. The resulting product is completely free of chlorides, sulfates, nitrates, calcium, and the acidity level varies from 5 to 7, which corresponds to the pH level of blood plasma. A special requirement for water quality is pyrogen-free. This is the absence of metabolic products of microorganisms. It is their penetration into the human body that leads to a sharp increase in temperature, chills, and feverish conditions.

Possible complications from Ceftriaxone for coronavirus in adults

When using Ceftriaxone for coronavirus, adverse reactions may occur, the most common being diarrhea. It can be mild and goes away after the intestinal microflora is restored; Linex and Lactofiltrum are prescribed for this.

Complications in the form of pseudomembranous colitis may also develop. This is an inflammation of the intestines that is very difficult to treat.

Also during treatment with Ceftriaxone the following were noted:

• headache;
• convulsive muscle twitching;
• dizziness;
• allergic reactions: skin itching, rashes, chills (drug fever);
• blood composition disorders - increased eosinophils, platelets, destruction of red blood cells, decreased leukocytes and lymphocytes;
• nausea, vomiting;
• change in taste sensations;
• abdominal pain and bloating;
• laboratory signs of deterioration in liver function (increased enzymes, bilirubin), jaundice occurs less frequently;
• bile stagnation (found on ultrasound);
• increased urea, creatinine in the blood due to kidney damage, cylinders and red blood cells, glucose in the urine;
• thrush;
• sweating, hot flashes;
• inflammation of the vein at the injection site.

Precautionary measures

Since several drugs are used at once for coronavirus pneumonia with complications, it is very important to take into account their combinations. Ceftriaxone is completely incompatible with calcium solutions, and when two antibacterial drugs are prescribed, they cannot be mixed in one dropper.

Also, due to the risk of deterioration of the kidneys and liver, you should constantly monitor the indicators of kidney and liver tests (biochemical blood test). In patients with coronavirus, Heparin is used; when it is combined with Ceftriaxone, the risk of bleeding increases, so therapy is carried out under the control of a coagulogram.

How to use the medicine

The dosage of water for injection depends on the amount of the drug that is diluted with it. As a rule, when determining an individual dosage regimen, the doctor indicates how much solvent should be used. In other cases, you should follow the recommendations of the instructions for use. But not water, but a drug that needs to be diluted.

Manufacturers of some medicines immediately put solvents in the packaging. But more often they need to be purchased separately. The annotation indicates which solvent is needed for a particular drug. If the medicine can only be diluted with isotonic sodium chloride solution, then you need to buy it. The use of water in such cases provokes a decrease in the therapeutic effectiveness of the active ingredients.

Before carrying out the treatment procedure, you must thoroughly wash your hands and dry them. Then proceed as follows:

remove the aluminum protective cap from the bottle with the drug;

open the ampoule of water and use a sterile syringe to take out the required volume;

use a syringe needle to pierce the rubber or plastic stopper of the bottle and inject the collected water;

Shake the bottle well, use the second syringe to take out the required amount of solution and inject.

Please note that it is not always necessary to shake the bottle until the substance is completely dissolved. Some pharmacological drugs are, in principle, incapable of dissolving in water. They are administered in the form of a suspension.

Why dilute Ceftriaxone?

Since Ceftriaxone is available in powder form, it must be dissolved before administration. The undissolved drug is used only in the form of powder for bedsores, ulcerative skin lesions and long-term non-healing wounds. Why dilute Ceftriaxone in patients? This only happens in cases of treatment at home. Sometimes sick people refuse medical care and make intramuscular injections on their own with the help of relatives or close people.

To dilute the drug at home, you must first of all have aseptic conditions. You should also stock up on antiseptics and tell your doctor how to dilute Ceftriaxone yourself. Intramuscular administration of antibiotics is a rather painful procedure, so a 1% solution of lidocaine or 50% novocaine is used to dilute them. These drugs significantly reduce the pain of the injection, but sometimes cause complex allergic reactions.

Therefore, before administration, you should test for an allergic reaction to both the antibiotic and the anesthetic. To do this, use an insulin syringe to inject a minimum dose of the drug diluted with water for injection onto the wrist. If after 20 minutes no changes appear at the injection site, the drug can be administered.

Special instructions for the use of water for injection

Water for injection is devoid of any pharmacological activity. This means that it has no contraindications for use and is not capable of provoking the development of local and systemic adverse reactions. Only drugs that have been diluted are responsible for all negative effects. In what cases can adverse reactions be caused by parenteral administration of water:

non-compliance with the instructions for use, use of water for injection for other purposes;

using an expired drug or storing the medicinal solution for too long under sterile conditions.

Some medications, for example, cephalosporin antibiotics, when administered parenterally, cause quite severe pain. Therefore, doctors recommend dissolving the powder simultaneously in both water and lidocaine with pronounced analgesic properties. If this method of performing the injection is not indicated in the instructions, then it is better to abandon it. Or ask your doctor to carefully calculate the dosage of solvents.

When preparing a medicinal dilution, care must be taken to ensure that it does not change its physical properties. The solution should not become cloudy or acquire uncharacteristic shades. Parenteral administration should be abandoned if sediment forms at the bottom when mixing two clear liquids. This indicates an undesirable drug interaction, the loss of the main drug’s therapeutic properties.

Is Ceftriaxone always possible for coronavirus and pneumonia?

Ceftriaxone for coronavirus is indicated for signs of bacterial pneumonia:

• chest pain on one side;
• asymmetrical wheezing;
• discharge of yellowish sputum;
• enlarged lymph nodes;
• In the blood test, leukocytes are elevated, there is a shift in the leukocyte formula to the left, high ESR and procalcitonin.

The antibiotic is not suitable for treatment at home (for mild forms of coronavirus); it is not prescribed for prophylactic purposes. Therefore, there is no point in administering it without a doctor’s prescription, this can only worsen the condition, lead to a more severe course of pneumonia; with unreasonable use, resistance to Ceftriaxone develops, and then it does not help when really necessary.

The medication is not recommended for patients when there is reason to assume that this drug is ineffective:

• less than 3 months before the illness there was already a course of treatment with Ceftriaxone;
• chronic inflammatory processes in the bronchi and lungs;
• recent injury, surgery;
• stay in nursing homes, closed boarding schools;
• the presence of a permanent catheter in a vein (for example, when an artificial kidney is connected to the machine).

For these groups of patients, other treatment regimens are chosen. Ceftriaxone may be discontinued after sputum culture results are obtained if the infectious agent is found to be resistant to this antibiotic.

Restrictions for use include:

• renal and/or liver failure;
• nonspecific ulcerative colitis;
• exacerbation of inflammation in the organs of the digestive system, especially the biliary tract and intestines.

An absolute contraindication includes an allergy to this antibiotic or another from the group of cephalosporins (for example, Cefotaxime, Cephalexin) or the penicillin series (a cross-allergic reaction is possible).

Where can I buy in Moscow and Odintsovo

Water for injection and other drug solvents are sold in all pharmacies. But you should buy them only in trusted medical institutions, whose employees carefully monitor their expiration dates and storage conditions. Such a responsible approach to the health of their clients is typical of pharmacists and pharmacists working in the largest pharmacy chain “Vasha No. 1”. It is well known among residents of Moscow and Odintsovo for its widest range of medicines and medical products. At Vasha No. 1 you can always buy them at a budget price. And the products sold are of the highest quality.

The pharmacy chain has long been extremely popular among residents of Moscow and Odintsovo. It is difficult to imagine a situation where a client left without the drug solvent he needed. Pharmacies are conveniently located, within walking distance from metro stations and bus stops. Soon it is planned to expand the network and open branches in other localities of the country. Now their residents will not have problems purchasing high-quality and inexpensive medicines.

Ceftriaxone intramuscularly: instructions

According to the instructions, the use of Ceftriaxone intramuscularly follows the following algorithm of actions for adults:

1. Fill a 5 ml syringe sequentially with water for injection 2 ml and Lidocaine 2% 2 ml, put a protective cap on the needle.
2. Remove the protective cap from the Ceftriaxone vial to expose the surface of the rubber stopper.
3. Puncture the rubber stopper with a needle and release the entire volume of solvent.
4. Mix the powder by shaking the bottle until it is completely transparent.
5. Draw the diluted antibiotic into the syringe, change the needle, and release excess air.
6. Select a location in the upper outer quadrant and wipe it with alcohol.
7. Insert the needle at a right angle to 2/3 of its length.
8. Slowly and smoothly pressing the plunger, inject the entire solution into the muscle.
9. Remove the needle and press the injection site with an alcohol swab.

Watch the video on how to properly inject an antibiotic intramuscularly:

For children weighing up to 50 kg, not the entire prepared solution is used for one injection. After determining the dose per 1 kg, calculate how much medication is needed, taking into account that 4 ml contains 1000 mg of antibiotic, and 1 ml, respectively, 250 mg.

Clinical examples

Ceftriaxone 2 g should be administered intramuscularly . To do this, dissolve 1 g of the drug in 4 ml of 1% Lidocaine, the second injection must be given in the other buttock immediately or after 12 hours.

How to calculate the dose of Ceftriaxone 340 mg intramuscularly . The method of using a fractional dose does not differ when diluting the antibiotic, that is, you need to take 1 g (1000 mg) of Ceftriaxone and add 4 ml of solvent. Then they calculate how much solution needs to be collected: 340x4/1000 = 1.36. Rounding will give you 1.4 ml. This means that one injection will require 1.4 ml of diluted antibiotic.

Ceftriaxone was prescribed 4 grams per day intramuscularly . Since 1 g of the drug can be injected into one buttock, you need to choose a convenient time with an interval of 12 hours (for example, 8 am and 8 pm) and each time make 2 injections into different buttocks: in the morning 2 g and in the evening 2 g. More correct The method for such a dose would be intravenous drip of antibiotic.

How long does it take for it to start working?

The onset of action of Ceftriaxone when administered intramuscularly occurs after 2-3 hours, since at this time the maximum concentration of the drug is detected in the blood. The first signs of relief usually occur on days 2-3 of treatment. The patient's body temperature decreases and the symptoms of infection disappear. If there is no result by the end of 3 days, you should definitely consult a doctor; you may need to change the drug.

How to prick - fast or slow

Ceftriaxone with Lidocaine should be injected intramuscularly slowly in order to reduce pain during injection and avoid the appearance of a lump after the injection. On average, an injection into the gluteal muscle should take about a minute; it is enough to gently press the piston.

Dosage for adults

The average dosage of Ceftriaxone for an adult is 1 g of the drug once a day; in case of severe infection, it is increased to 2 g (1 g in each buttock). If necessary, it can reach a maximum of 4 g per day. Special cases:

• acute uncomplicated gonorrhea – 250 mg intramuscularly once (one injection);
• tick-borne borreliosis – 2 g per day;
• prevention of infectious complications before surgery - 1-2 g are administered per hour, depending on the expected danger;
• for renal failure and hemodialysis (artificial kidney machine) - no more than 2 g per day;
• infection with a risk of spread, complications and in patients with immunodeficiency – 2-4 g;
• sepsis – 4 years

Dose for children

For children, the dose of Ceftriaxone should be calculated per 1 kg of body weight (see table).

For example, you need to calculate the dosage of Ceftriaxone for children 2 years old with moderate pneumonia (intramuscular administration). The child's weight is 11 kg, so 50x11 = 550 mg per day will be required. For one injection, take 1 g of the drug and 4 ml of 1% Lidocaine. The daily dose is (550 x 4/1000) 2.2 ml, it can be administered at a time.

How many days to inject

For most infections, ceftriaxone should be injected until the temperature drops and the main symptoms subside, and then for another 2-3 days.

It is recommended to adhere to the following rules:

• minimum course – 5 days (except for special cases), average – one week;
• meningitis – meningococcal 4 days, pneumococcal – 7 days, caused by Haemophilus influenzae – 6 days;
• acute uncomplicated gonorrhea – 1 day;
• acute otitis media without the risk of spreading infection – 1-3 days;
• syphilis – 10-14 days;
• tick-borne borreliosis – 3 weeks;
• streptococcal infection – at least 10 days.

There is no maximum duration of the course, but if long-term treatment is necessary, doctors most often change the antibiotic after 1.5-2 weeks.

Dosage for dogs and cats

For cats and dogs, the daily dose is calculated by weight - 30-50 mg per 1 kg. Novocaine is used as a solvent, since Lidocaine is toxic to animals.

To give, for example, an injection to a cat weighing 7 kg, you will need:

• 1 bottle of Ceftriaxone;
• 1 ampoule with 2 ml of water for injection;
• 1 ampoule of 0.5% Novocaine (2 ml needed).

2 ml of water for injection and 2 ml of 0.5% Novocaine are taken into the syringe to obtain 4 ml of a 0.25% solution. It is completely filled into the bottle. For one day you need 7x50 = 350 mg of Ceftriaxone, which corresponds to 350x4/1000 = 1.4 ml. This volume is injected into the hind paw intramuscularly once a day.

Does it hurt to insert

Ceftriaxone is painful to administer, so it is diluted with 1% lidocaine. This helps reduce pain, but discomfort may persist both at the time of injection and for several hours after. When hardening occurs, it is recommended to apply an iodine mesh to the injection site.

Ceftriaxone intramuscularly: price

If you inject Ceftriaxone intramuscularly, the price of treatment will be one of the lowest - a 1 g bottle costs 26-48 rubles. Therefore, an average weekly course with a solvent will cost approximately 300-500 rubles. This cost is possible for a Russian drug, but the original antibiotic Rocephin is almost 10 times more expensive.

In which online store can you find any solvents for medications?

The Vasha No. 1 pharmacy chain is very popular thanks to the online store created on its basis. It is convenient to make purchases here, track bonuses and discounts, and store the necessary information about injectable drugs and means for their dilution that were previously purchased. There are many advantages to placing an order at the “Your No. 1” online pharmacy. What is she known for:

100% guarantee of high quality medicines;

simple ordering;

frequent bonuses and discounts from the online store and manufacturers;

24/7 communication with operators;

availability of quality certificates.

The online pharmacy “Your No. 1” sells a variety of medications for dissolving medications. Here you can buy inexpensive water for injection in glass or plastic ampoules from domestic manufacturers. Imported Ringer's and glucose solutions are also sold, which never provoke the development of adverse reactions.

Features of therapy

When using ceftriaxone as the primary therapy for pneumonia, it is important to remember the following specific features:

1. In severe cases of pneumonia, the intravenous route of administration is preferable to the intramuscular route due to greater bioavailability and rapid onset of action.
2. If the patient has a history of allergic reactions to penicillins (amoxicillin, ampicillin), there is a high probability of cross-allergy to ceftriaxone.
3. With good efficacy and tolerability of ceftriaxone, it is possible to carry out stepwise therapy, i.e. subsequent transfer of the patient to taking tablet drugs from the cephalosoprin group.
4. If atypical pneumonia is suspected in some patients, it is advisable to use initial therapy in the form of a combination of ceftriaxone and macrolides (erythromycin, azithromycin).

How to order medications for dissolving medications from the warehouse

You should definitely take advantage of this function of the “Your No. 1” online store. All pharmacological preparations, including those intended for diluting other drugs, which are stored in the pharmacy warehouse are significantly cheaper. Markups are made by employees only after they are delivered to the branches. Therefore, it is possible to buy water for injection, isotonic solution or glucose solution at a reduced cost. True, you will have to wait 1-2 days until you receive an SMS notification or email asking you to pick up the required medication from the pharmacy closest to your home.

Which is better - intramuscular or intravenous?

For Ceftriaxone, intravenous injections are better than intramuscular injections for severe infections. Moreover, both routes of administration have high antibacterial effectiveness, but differ in pharmacokinetic properties, that is, in the rate of entry into the blood and elimination (see table).

It is better to inject an antibiotic into a vein in such cases:

• high doses are needed (from 2 to 4 g per day);
• there is intolerance to lidocaine (painkiller);
• Treatment is carried out on a newborn or a child under 3 years of age.

Recipe

To purchase Ceftriaxone, you need a prescription from a doctor; it is prescribed according to this example:

Rp.: Ceftriaxoni 1.0

1. td no. 7
2. Dilute the contents of the bottle with 4 ml of 1% Lidocaine and administer intramuscularly once a day for 7 days.

Contraindications to antibiotics

Ceftriaxone is contraindicated in case of intolerance or allergy to any drug from the group of cephalosporins, penicillins, carbapenems. This antibiotic cannot be administered intramuscularly in case of allergic reactions to lidocaine or a ban on its use (epilepsy, heart rhythm disturbances - blockade, bradycardia, weakness of the sinus node).

There are special restrictions for newborns:

• premature;
• the need to introduce calcium salts;
• increased level of bilirubin in the blood, jaundice;
• low protein levels;
• a shift in blood pH to the acidic side (acidosis).

Side effects

Ceftriaxone is a non-toxic drug, but its use is always carried out under the supervision of a physician due to the risk of adverse reactions:

• digestive system - diarrhea, intestinal dysbiosis, nausea and vomiting, abdominal pain, loss of appetite and unpleasant taste in the mouth;
• biliary tract - precipitation of salts, increased bilirubin and liver enzyme activity, drug-induced hepatitis, jaundice;
• blood - increased eosinophils (a sign of allergy), decreased leukocytes (responsible for immunity), platelets (increased bleeding), anemia;
• nervous system – dizziness, headache, convulsions;
• kidneys and urinary tract - deterioration of renal function, decreased urine output, salt deposition in the kidneys;
• immunity - allergic reactions, including the rapid increase in swelling of the face and neck, urticaria, anaphylactic shock, rashes; due to decreased immunity, the development of thrush or a second infection is possible;
• respiratory tract - bronchospasm with paroxysmal cough;
• local reactions – pain upon insertion, hardening.

If any unusual symptoms appear during treatment, you should consult a doctor.

Search for drug solvents in the online pharmacy “Your No. 1”

The online pharmacy “Your No. 1” has an intuitive interface. Creating a personal account greatly simplifies the search for drugs and their solvents. You need to fill out the table by entering your name, contact phone number or email address in its columns. Your personal account is ready to track order statuses, receive discounts and bonuses, and store information about purchases made. Finding a drug dissolving agent in the catalog is not difficult - you need to use one of these methods:

scroll the alphabetical index to the letter “b” if you need water for injection;

enter the first letters “water d” into the search bar to open the entire range of water with various volumes of ampoules;

click on the catalog, find the column “Medicines” then “Dissolvents for drugs”, select the required product, study its dosage regimen, indications for use, expiration dates.

And the easiest way to find water for injection, sodium chloride solutions, glucose is to go to your personal account and put the drug back into the “Basket”. But this can be done provided that it has already been purchased previously and was added to the “Favorites” section.

What is best for diluting the drug?

What else is this antibiotic diluted with, besides lidocaine and novocaine? Sodium chloride and even distilled water are often used as a solvent. To understand which solvent is better, you should consider that:

• injection with an aqueous solution is more painful than with an anesthetic solution;
• Each patient has an individual sensation of pain in response to a particular solvent;
• the body may not accept the solvent or its components.

Therefore, each patient is first tested to determine the tolerance and intensity of pain. The essence of the test: two small scratches are made on the hand. Literally a drop of antibiotic and solvent is applied to them. If within 5-10 minutes there is no redness or swelling in these areas, and the patient does not experience pain, then this solvent is suitable for him.

For intramuscular injection

Both the manufacturer and medical practitioners recommend using Ceftriaxone with lidocaine to reduce acute pain during intramuscular injection of an antibiotic. This injection is less painful than an injection based on novocaine, and the likelihood of adverse reactions is significantly reduced.

When administered intravenously using a syringe

To increase the effectiveness of the antibiotic’s effect on the body and reduce the discomfort from the pain experienced by the patient, the drug is administered intravenously.

For intravenous injections with a syringe, anesthetics are not used as a solvent for Ceftriaxone. The drug is diluted exclusively with water for injection. To reduce pain, the solution from a syringe is injected deeply, smoothly and slowly (at least 2-4 minutes).

When infused into a vein using a dropper (infusion)

If the jet injection of the drug with a syringe (even slowly) causes discomfort in the patient, then an infusion (dropper) is prescribed at a dosage of the drug of 1 mg or higher. In this case, Ceftriaxone is diluted with a 0.09% sodium chloride solution. Reduction of pain is achieved through the use of a drip (gradual) administration of the drug. For example, a solution with a volume of 1000 ml is administered over 30 minutes.

As a rule, IVs are placed in hospitals. But drip administration of the composition at home is not prohibited, provided that the patient is monitored by a qualified healthcare professional.

How to find out the price (cost) of drug solvents

The search for a drug solvent in the online pharmacy “Your No. 1” ends with the opening of its image. Nearby is detailed information about the manufacturer, pharmacological properties, and restrictions on use. The price is indicated here, and not even just one. The lower one indicates how much it will cost to purchase a drug solvent if you pre-order its delivery from the warehouse. A little lower there is a higher cost. It informs about the price of water or solution, which is currently available in the “Your No. 1” pharmacy closest to the client’s place of residence.

What to do if the drug does not help

The criteria for insufficient effectiveness of ceftriaxone therapy are:

• no improvement in the patient's condition: increasing shortness of breath, severe cough, persistent fever;
• persistence of purulent sputum;
• lack of positive dynamics in laboratory parameters: increase in the level of leukocytes with a band shift to the left; increase in ESR;
• no improvement according to chest x-ray.

If the above signs are present, there is a high probability of the participation of atypical pathogens in the infectious process: mycoplasmas, chlamydia, legionella . To increase the effectiveness of antibiotic therapy in this case, it is advisable to use a combination of ceftriaxone with drugs from the macrolide group (clarithromycin, azithromycin).

IMPORTANT! The decision to prescribe treatment with ceftriaxone, discontinue it, or change it to another antibacterial drug should be carried out only under the supervision of a physician.

If this combination of antibiotics turns out to be ineffective, it is necessary to decide on a radical change from ceftriaxone to other antibiotics (fluoroquinolones, carbapenems, etc.), and also consider the possibility of an alternative diagnosis: tuberculosis, lung abscess, pneumonia of viral origin, etc.

Types of antibiotics

All types of drugs have a strong effect and include a wide range of effects on pathogenic microorganisms.

Amoxiclav

A complex drug that includes amoxicillin actively fights viral infection. The second component, clavulanic acid, inhibits bacterial synthesis. The antibiotic is indicated for symptoms such as:

• bronchitis;
• pneumonia;
• lung abscess.

If the virus has entered the bloodstream, the medication will quickly help cope with sepsis.

Side effects may include:

• jaundice, hepatitis, impaired stool formation;
• allergic reactions;
• kidney inflammation;
• candidiasis.

Fluimucil

The drug contains triamphenicol. Used as inhalation and injection. The antibiotic has expectorant, mucolytic and bactericidal properties. When the patient has a moderate condition, he is prescribed inhalations with the drug. The substance is absorbed into the bloodstream in small quantities, so the risk of side effects is minimal. However, they still exist and can be expressed in the form of an allergic rash, stomatitis, and pancytopenia.

Azithromycin

An antibiotic is one of the most potent drugs. Produced in ampoules and tablets, it can be used both intravenously and intramuscularly. Actively affects bacterial cells by suppressing protein synthesis, reproduction, and enzymes. Effectively fights otitis, sinusitis, tonsillitis, bronchitis.

The drug is indicated for identifying infectious pathologies caused by inflammation of the respiratory tract, and therefore can be used to treat coronavirus. There are a lot of side effects, however, they can be avoided if you follow the recommendations for use.

Ceftriaxone

The drug has a strong effect on pathogenic microorganisms. When it enters the body, a bactericidal effect occurs, all bacteria are destroyed, which eliminates the risk of chronic diseases. The drug is usually prescribed during the complicated viral phase. Side effects may include:

• candidiasis;
• allergic rash;
• dyspepsia;
• kidney inflammation.

Levofloxacin

The antibiotic can cope with gram-negative and gram-positive bacteria that are found in adults. For coronavirus, the medicine is used to treat pathogenic microbes. The patient is prescribed to take the drug when there are pronounced symptoms of pneumonia and bronchitis.

The toxicity of the antibiotic is average, it spreads throughout the body and can cause side effects in the following systems:

• cardiovascular
• immune;
• musculoskeletal;
• nervous.

Sources

• https://gaimorit-stop.ru/preparaty/dioksidin-i-ceftriakson.html
• https://ceftriakson.online/czeftriakson-pri-pnevmonii/
• https://ceftriakson.online/czeftriakson-vnutrimyshechno/
• https://endokrinolog.online/ceftriakson-pri-koronaviruse/
• https://ceftriakson.online/skolko-dnej-kolot-czeftriakson/
• https://med-kurator.com/organy-dyhaniya/pnevmoniya/antibiotiki/tseftrikason.html
• https://sosudy.info/antibiotiki-pri-koronaviruse
• https://aptstore.ru/articles/antibiotiki-pri-koronaviruse/