Ceftriaxone, an Empirical Goldmine: A Systematic Review of Randomized Controlled Trials

Department of Pharmacy, University of Science and Technology Chittagong (USTC), Chattogram, Bangladesh

*Corresponding author: Md. Shahidul Islam, Assistant Professor, Department of Pharmacy, University of Science & Technology Chittagong (USTC), Chattogram, Bangladesh, E-mail: [email protected].

Received Date: August 28, 2020

Published Date: October 01, 2020

Copyright: Islam MS. ©2020.

Citation: Islam MS, Shirin M. (2020). Ceftriaxone, an Empirical Goldmine: A Systematic Review of Randomized Controlled Trials. Mathews J Pharm Sci. 4(1):01.

ABSTRACT

Empiric therapy for community and health-care associated bacterial infections with high mortality is challenging with the continued development of resistant strains and the threat of multi-drug–resistant organisms. Pharmacists may impact patients’ outcomes by appropriately selecting initial antibiotic treatment, screening for duplication of therapy, and identifying the duration of therapy, regardless of whether a facility holds an antimicrobial stewardship program in place. The choice of ceftriaxone as an empiric therapy has been under-represented in many ways and its choice as first-line antibiotic in fatal infections remain controversial. To investigate the current state of ceftriaxone, alone or as a part of step-down therapy, therapy in terms of clinical and bacteriological efficacy, as well as evaluate the economic burden intravenous ceftriaxone therapy poses in patients with six infections associated with severe mortality and morbidity worldwide and assess the reliability of ceftriaxone as an empirical therapy in these six infections since the increased threat of multi-drug resistant organisms. This systemic review with meta-analysis of randomized controlled trials involves the assessment of the clinical and microbiological efficacy of ceftriaxone compared with that of other antibiotics in community-acquired pneumonia, bacterial meningitis, acute pyelonephritis, gonorrhoea, complicated intra-abdominal infections and efficacy in the perioperative prophylaxis of local and systemic infections published in the dates between1990 to 2019 was performed. The electronic databases of PubMed, the Cochrane Central Register of Controlled Trials and Google Scholar were reviewed to search for relevant randomized controlled trials. Additional references, review papers, and proceedings of seminars were also searched. The simplified once-daily administration of ceftriaxone, due to its long elimination half-life, compared to otherwise complicated regimens of other antimicrobials has given a superior advantage in a hospital setting as well as a in an ambulatory setting as a parenteral agent. The well-endowed tolerability profile and favorable pharmacokinetic profile has indeed cemented ceftriaxone as a drug of choice among the other cephalosporins in the treatment of both serious community-acquired and hospital-acquired infections.

KEYWORDS: Ceftriaxone; Review; Diseases; Efficacy; Cephalosporins