Ceftriaxone uses, advantages and disadvantages.

Yuritza Medina

Florida National University

Ceftriaxone is an antibiotic used to treat many kinds of bacterial infections, including severe or life-threatening forms such as meningitis, Acinetobacter and Enterobacter species, hemophilic influenzae (including beta lactamase producing strains), Klebsiellosis pneumoniae, organelle, Neisseria and Proteus species, and Serratia marcescens. It possesses activity against most strains of Staphylococcus aureus and Streptococcus pneumoniae, but Staphylococcus epidermidis, methicillin-resistant strains of staphylococcus, and Enterococcus faecalis (Group D streptococci) are typically resistant. Ceftriaxone has poor activity against anaerobes. Ceftriaxone has a long serum life, time that the drug takes for its concentration in the body to reduce by half compared to other antibiotics for bacterial infections. This allows it to be taken after twelve hours in children and twenty four hours in adults. However the use of Ceftriaxone causes leads to serious side effects that include severe skin reactions. The skin reactions include burning of the eyes, swelling of face or tongue, skin pain, blistering and peeling of the skin. It also causes serious allergic reactions such as hives and breathing difficulties on individuals allergic to any of its ingredients. Ceftriaxone is commonly used in the treatment of acute gonorrhea of the lining of the uterine walls. Ceftriaxone is generally recognized to be safe and effective when administered either intravenously or intramuscularly to both adults and children as a single drug for skin and skin structure infections. An advantage of ceftriaxone over the other third-generation cephalosporins is its long serum half-life, which allows it to be given every 12 hours in children and every 24 hours in most adults. There is no question that ceftriaxone is effective for skin and soft tissue infections, particularly those caused by staphylococci and streptococci. The drug’s sales to home infusion companies around the country attest to its widespread use for such infections.

The fact remains, however, that the data required to substantiate efficacy and safety for ceftriaxone or for any of the other third-generation cephalosporins are just not available in large numbers. There are some disadvantages in the use of ceftriaxone for example, the costs involved in the acquisition and administration of ceftriaxone must be weighed against its convenience in the out-patient setting. Single-dose therapy is still significantly more expensive than oral antibiotics in most areas. In addition, concern exists with the potential for the development of bacterial resistance with overuse of this agent in children. Issues such as these must be more fully evaluated before clinicians adopt the wide-spread use of ceftriaxone for relatively self-limiting conditions such as otitis media. Ceftriaxone is poorly absorbed from the gastrointestinal tract and must be given parenterally. Like other cephalosporins, it is widely distributed throughout the body. It reaches the cerebrospinal fluid in adequate concentrations through inflamed meninges to effectively treat meningitis. Unlike most other cephalosporins, ceftriaxone is highly protein-bound. Controversy remains over the significance of ceftriaxone’s displacement of bilirubin from protein binding sites in neonates. Although several clinical trials have documented the safety of ceftriaxone in the neonatal population, many clinicians continue to avoid its use in this population, particularly in premature neonates or those with hyperbilirubinemia. Ceftriaxone is 60 to 70% eliminated as unchanged drug by renal excretion. The remainder is secreted unchanged in the bile. The long elimination half-life of ceftriaxone, approximately 6 to 9 hours in adults and 5 to 18 hours in infants and children, allows for once or twice daily dosing.

References

Truter, I. (January 01, 2015). Antimicrobial prescribing in South Africa using a large pharmacy database: a drug utilization study: original research – autopsies at an academic hospital. Southern African Journal of Infectious Diseases, 30, 2, 52-56.

  PART 1 

First week I created PICOT ,

n hospitalized adult patients, how does an educational program on central line management compare to no educational program in the prevention of central line-associated bloodstream infections?
P: Patients with Central lines in MICU or hospitalized
I: educational interventions for staff and patients.
C  Educational program compare to no educational program.
O: decrease rate  of CLABSIs
T: within 90 days of process improvement implementation.
I am interested in Central line bloodstream infections (CLABIS).by using educational initiative could decrease the rate of catheter-associated bloodstream infection. mandatory education program offered to  ICU nurses and physicians. it was developed by a multidisciplinary task force to highlight correct practices for the prevention of catheter-associated bloodstream infection.
In this program, they included  10-page self-study module on risk factors and practice modifications involved in catheter-related bloodstream infections and in-services at scheduled staff meetings for their staff. Seventy-four episodes of catheter-associated bloodstream infection occurred in 7,879 catheter-days in the 24 months before the introduction of the education program.
Following implementation educational of the intervention, the rate of catheter-associated bloodstream infection decreased to 41 episodes in 7,455 catheter days. The estimated cost savings secondary to the decreased rate of catheter-associated bloodstream infection for the 24 months following the introduction of the education program was between $103,600 and $1,573,000.
Educational intervention main focused on the education of health-care providers on the prevention of catheter-associated bloodstream infections. it may lead to a dramatic decrease in the incidence of primary bloodstream infections. Education programs may lead to a substantial decrease in medical-care costs and patient morbidity attributed to central venous catheterization when implemented as part of mandatory training.

References:
The Effect of an Education Program on the Incidence of Central Venous Catheter-Associated Bloodstream Infection in a Medical ICU.Warren D.K., Zack J.E., Mayfield J.L., Chen A., Prentice D., Fraser V.J., Kollef M.H. (2004)  Chest,  126  (5) , pp. 1612-1618

PART 2 need to be done

WEEK 3 

The purpose of assignments Part 1-3 is to gradually guide the student in developing the signature assignment. The idea is for the student to take ia stepwise approach to completing the signature assignment. The signature assignment will be divided up into three steps: STEP 1 – Introduction and Overview of the Problem; STEP 2 – Project Purpose Statement, Background & Significance and PICOt Formatted Clinical Project Question; and STEP 3 – Literature Review and Critical Appraisal of Literature. The three steps will be put together with the final signature assignment in week 8. This assignment is STEP 1 – Introduction and Problem Statement.

1. Provide a title that conveys or describes the assignment.

2. Introduction (25 to 50 words) – Provide an introduction to your topic or project. The introduction gives the reader an accurate, concrete understanding what the project will cover and what can be gained from implementation of this project.

3. Overview of the Problem (50 to 70 words) – Provide a synopsis of the problem and some indication of why the problem is worth exploring or what contribution the proposed project is apt to make to practice.

4. References – Provide references used in the template using APA 6th ed. Manual.

PLZ USE Research article  should be within5 yrs.