Recently, a lot of life-threatening complications were reported after the use of " Ceftriaxone" vials, complications may be severe to cause death!!!!! I am looking for personal experience among clinicians and researchers to formulate this research problem into the right frame. with any reported trusted figures for those complications
I think that skin test for hypersensitivity reaction should be done before giving any antibiotics including ceftriaxone.
The fatal adverse events associated with ceftriaxone occurred because of
1-inappropriate drug usage, and drug overdoses,
2- careless medical personnel,
3- poor medical conditions,
4- poor drug quality ; not original formula
All these cause make its adverse effects fatal
Sorry, dr. Ahmed Bader ..what do you mean by careless medical personnel??? And poor medical conitiins???
For dr. Yones and dr. Tamoum .. I guess the only known antibiotic with hypersensitivity test is penicillin and its derivatives .Do you have any proof from literature about other antibiotic hypersensitivity tests?? Or it is personal emprical experience??
Pattern of cephalosporin use and incidence of CDI across Europe 2012-2013
•EUCLID (the EUropean, multicentre, prospective biannual point prevalence study of CLostridium difficile Infection in hospitalized patients with Diarrhoea)
•CDI incidence decreases as cephalosporin use increases.
•reduce CDI risk by restricting the use of a small number of antibiotic classes (such as cephalosporins and clindamycin) may fail to reduce the overall incidence of CDI, because those agents may be replaced by antibiotics with a similar risk of CDI (such as fluoroquinolones and β-lactam/β-lactamase inhibitors).
•Thus, a balanced approach to antibiotic stewardship may be more beneficial.
•J Antimicrob Chemother. 2017 Jan; 72(1): 1–18.
In 2007, there was a warning from FDA regarding interaction of ceftriaxone with calcium ions. There were several fatal cases reported, particularly in neonates who were administered ceftriaxone and total parenteral nutrition admixtures or other i.v. fluids containing calcium ions (Ringer's solution and Ringer's lactate solution). The drug combined with calcium caused precipitation, and it was found that it could happen, not only when mixed in one container or administered with Y-site connector, but can even occur in a bloodstream. The precipitates ocluded small arteries in lungs causing pulmonary insufficiency and even death. Therefore, the advise was to avoid any infusion of calcium ions at least for 48 hours after ceftriaxone administration.
However, no such case was reported in adults.
You can find more information in:
1. Can J Hosp Pharm. 2009 Mar-Apr; 62(2): 157–158.
2. Burkiewicz JS. Incompatibility of ceftriaxone sodium with lactated Ringer’s injection. Am J Health Syst Pharm. 1999;56(4):384.
3. Rapp RP, Kuhn R. Clinical pharmaceutics and calcium ceftriaxone [letter] Ann Pharmacother. 2007;42(12):2072.
There is also warning in summary of product characteristics for the ceftriaxone injection:
https://www.ema.europa.eu/documents/referral/rocephin-article-30-referral-annex-iii_en.pdf
I hope, this can be some help for you.
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