No test could be done, but he wanted to be sure after I told him Doxy alone failed two times, once 7 days 200mg and once 21 days 200mg. Is he trying to kill me or should I just take the regimen? He wants me to start taking doxy and moxi both today. I was injected today as well.
I accidently gave my cat 3ml Ceftriaxone Sodium with his saline under skin. Instead to 0.3ml in his muscles. What should i do now?
Age 25 Gender male PMH nil PSH nil Meds. Nil Allergy. Nil Social H. Non smoker. Non drinker. No illicit drug use. Sexually active
Patient had an unprotected sex with unknown person.
After 2 days he developed mucoid yellowish urethral discharge
He did Gram stain which showed Gonorrhea, and AG test which was negative for chlamydia.
Started on cefexime 400 once and azithromycine 1 G once.
Then Sx dissappeared.
After 3 W he has the same Sx again
Started on ceftriaxone 1G IV once and doxycycline 100 MG BD for 7 days.
SX Dissappeared then returned after 3 W.
What should be the next stip?
1 - Say you have Bacteria X, and you try to kill it with Azithromycin, millions survive. Then you try to kill it with Doxycycline, will doxycycline have an easier time to eliminate it, or is the remaining bacteria now more resistant?
2 - Say you have Bacteria X, and you try to kill it with Azithromycin, millions survive. Then you try to kill it with Ceftriaxone, will ceftriaxone have an easier time to eliminate it, or is the remaining bacteria now more resistant?
Was IV Rocephin (aka ceftriaxone) very helpful for anyone? Or bad or meh? Please share! I’ve been trying to push for this while I have a PICC line (for administering my POTS 2 liters of saline daily and my IVIG) but my doctor really likes new more experimental stuff. They keep almost doing it before changing their mind to do other things and I want to know if it has been a helpful thing for you guys.
If it’s important for background I’m a long time lymie who started becoming symptomatic when a was a tween, but despite being disabled by it I didn’t get an accurate diagnosis of bart/bab/borrellia until over 10 years later when a lot of damage had been done and everything was deeply entrenched. I’ve done a handful of years worth of lyme treatment now and so many of the typical things and atypical things but never Rocephin (aka ceftriaxone.)
Are there any other potent options for neurological lyme besides rocephin (ceftriaxone)? Unfortunately, I have a lot of problems with my gallbladder and am not sure, if I would tolerate rocephin. Thank you for any input.
Hi Meddit,
I was reading an UpToDate Article that I’ll do my best to summarize.
- Neisseria Gonorrhea has been building rapid resistance to Azithromycin over the years
- Ceftriaxone appears to be the only drug to maintain effectiveness against Neisseria Gonorrhea
- Neisseria Gonorrhea will be a public health crisis if it develops resistance to Ceftriaxone
- Doxycycline is more effective against Neisseria Gonorrhea than Azithromycin
- Azithromycin & Doxycycline have similar efficacy against Chlamydia and Chlamydia has not shown resistance to these drugs over the years.
The article acknowledges the disadvantages of 2x day dosing for a week for Doxy vs. One-time dose for Azithromycin.
Sena, MD, Arlene, and Myron Cohen, MD. “Treatment of Uncomplicated Neisseria Gonorrhea Infections.” Evidence-Based Clinical Decision Support at the Point of Care | UpToDate**, UpToDate, 2021, https://www.uptodate.com/contents/treatment-of-uncomplicated-neisseria-gonorrhoeae-infections?search=neisseria%20gonorrhea&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#references.**
Hello. I tested positive for syphilis a week ago. My titer level was 1:8. The place I went for treatment didn’t have penicillin so they gave me a shot of Ceftriaxone. Will that be good enough to treat syphilis? Should I go to a different clinic and get shot of penicillin? Any advice would be helpful.
I finished a 28 day course of intravenous Ceftriaxone on Dec 9, my Doc said my neuro lymes symptoms will get worse before they get better? During treatment and for the first few weeks i felt great but now nearly a month later my symptoms are coming back, anyone experience this?
What do we think folks for a patient that already has an IV line?
PK seems very similar between IV and IM especially from the 4 hour mark on.
accessdata.fda.gov/drugsatfda_docs/label/2009/0550585s063lbl.pdf
I was diagnosed with Lyme in January, though I’ve likely had it for 8-10 years. Did two rounds of doxycycline, and yesterday I started on ceftriaxone IV.
Today I woke up with every joint in my body aching. I feel totally exhausted after 8 hours sleep.
I’m scripted nucynta, and that isn’t helping this pain at all. Does this sound like a herx reaction? If so, how long do they last?
Thanks for all your help.
I’m on day 4 of Ceftriaxone IV therapy. It is annihilating me. I can barely get out of bed and every joint in my body is on fire.
Anyone have a similar experience or tips to help me? I can’t do this for 24 more days, but I cant keep living with Lyme either....
Sorry for being a n00b here: I have a patient on Caspofungin, Daptomycin and ceftriaxone all being run through a single lumen PICC at 7:30, 9:00 and 11:00 respectively. Trissels states that Caspo and Ceftriax incompatible at a y-site.
Is this safe to run the IVs like this as long as the nurses follow SAS (saline, ABX, saline)? Should we consider a double lumen PICC line instead? Or can we just change the administration time of Ceftriaxone?
I’m only asking because I am unfamiliar and just broke into IV territory.
thanks in advance for your time and help
Reading the instructions for Ceftriaxone 500mg/vial, the vial states: For IM administration- “reconstitute with 1ml 1% lidocaine or sterile water. Each 1ml of solution contains approximately 350mg equivalent of ceftriaxone”. For IV administration- “reconstitute with 4.8ml of an IV diluent... for each 1ml of solution contains approximately 100mg equivalent of Ceftriaxone”. Reading the instructions for Ceftriaxone 1000mg/vial, the vial states: For IM administration- “reconstitute with 2.1ml 1% lidocaine or sterile water. Each 1ml of solution contains approximately 350mg equivalent of ceftriaxone” For IV administration- “see package insert”.
When reconstituting the 500mg/vial with 1ml Lidocaine/sterile water/sterile saline I get a total volume of roughly 1.1ml with no residual powder visualized. With the 1000mg vial reconstituted, I get 2.6ml total. As per the instructions, if each reconstituted volume is equal to 350mg/ml- does the 500mg vial not equal 350mg and the 1000mg vial not equal 810mg? This obviously can’t be the case since the total dose is 500mg and 1000mg... am I looking at this wrong or is there something that’s confusing?
See page 18- https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/0550585s063lbl.pdf
Pic of 500mg/vial- https://i.imgur.com/DInp8nW.jpg
Another example, had to give 820mg IM to peds pt (3F) to treat pneumonia. Put 2.1ml lido into 1G vial yielding 2.6ml total volume when pulled back into the syringe. My pharmacist said that I should of initially reconstituted w/ 4ml lido but since I did 2.1ml the dose would be 1.8ml. This dose seems short but that’s what we gave. We are a small community hospital with an even smaller peds population through the ER only. We do not have an in-house pharmacist at night but do have a larger sister hospital who does call for us and well as med verification.
Thank you for your assistance, knowledge, and education!
I started the 28 day course because one joint showed swelling, although both had these sharp cut-like pain episodes. Now, week in the treatment, i noticed both leg joints are more swelled compared to pre-treatment. Is it normal in your opinion?
"We ask you provide at minimum your age, approximate height & weight, gender, medications you take, smoking status, previous and current medical issues, duration and location of complaint, and a photo (if it's a skin issue)."
I am male. 36. 5 feet and 8 inches. 175 lbs. I'm on Flowmax but it doesn't help much. Not a smoker.
https://ibb.co/e4KWvx (Picture).
Here is my story and I hope someone can help. I'll try to keep it concise.
In 2008, at Providence Milwaukee Hospital in Oregon, I had been given an injection of the antibiotic Ceftriaxone / Rocephin, for what they say was epididimitis. My left testicle had tilted forward on its axis and I thought I had torsion. They said epididimitis. They gave me Ceftriaxone injection in the inner left thigh. Given a 7 day supply of doxycycline. Well, I went home and looked through the discharge papers which said "to relieve pain from epididimitis, try a hot sitz bath." So I did... I ran a hot bath and tried to sit down in the tub. IMMEDIATELY my left side of scrotum filled with fluid. My left testicle went from being relatively small to the size of a chicken egg.
I didn't understand what happened. I didn't even -think- to call for paramedics. Holy hell, I should have. I didn't think anything of it. I took the doxy and carried on with life as if everything was normal, despite having a left testicle that was swollen. My right one functioned normal.
Then fast forward to 2017, years had passed and I had forgotten the events from before. The old saying goes if you forget history you're doomed to repeat it. And I repeated it alright....
I had the same tilting going on in the right testicle, I usually just pushed it back into the upright position myself and it was fine. But this time I went to Seventh Day Adventist Hospital in Portland, they said "epididimitis" and gave me the Rocephin shot again... In the right ass cheek, and the prescription for doxycycline. My memories were faded, I had forgotten that name "Rocephin" - but Doxycycline kinda bounced in my head. "Where have I heard that before."
I went home. Looking at my discharge papers. "Hot sitz bath." I got in the tub... The same exact thing happened. Right testicle swelled up. Scrotum on that side puffed up. The memories flooded back. "Oh God, what did I just do! I did it again!!! You idiot!"
This time I called for an ambulance. They put me in thin pajama bottoms so as to not put any pressure on my scrotum and they rushed me off to another hospital i
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