Ceftriaxone for Patients Hospitalized with Pneumonia: One Gram or Two?

In a cohort of patients in Japan with mean body weight of 50 kg, only those receiving mechanical ventilation benefited from the 2-g dose.

In their 2019 guidelines, The American Thoracic Society and the Infectious Diseases Society of America recommend 1 to 2 g ceftriaxone for patients hospitalized with community-acquired pneumonia (CAP), without precise advice about dosing.

In a retrospective cohort study, researchers in Japan identified 470,000 hospitalized patients with CAP (≈55% male; mean body weight, ≈50 kg); 63% of patients received 2 g ceftriaxone and 37% received 1 g ceftriaxone for a mean of 7 days. Thirty-day mortality was about 4.5% overall, without significant differences between dosage groups. However, patients with severe CAP who received 2 g ceftriaxone had significantly lower 30-day mortality (17% vs. 20%).

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases