INDICES> Ceftriaxone Protocols/Guidelines

[pharmacy@palaunet.com]

Dear Friends,

I am having difficulty at present controling the usage and dosages of
Ceftriaxone within our National Hospital.  Our usage of Ceftriaxone has
gone up roughly 400% over the last 8 months and is impacting adversely
on our drug budget.

As my access to information in the way of journal etc is rather limited
here and most of my reference are out of date I would be grateful for
any assistance that could be provided as to the appropiate and rational
current usage of Ceftriaxone that I may present to the Medical Staff
within the hospital.

One problem I have in particular is with its dosage in children.  Most
of the reference we have available within the hospital give a dosage for
children of 50-100mg/kg every 24 hours up to a maximum of 4g (e.g  The
Harriot and Lane Handbook).  This however results with even small
children being put on rather large dosages of Ceftriaxone when compared
to those recommended for adults (1 to 2 grams daily) despite their
smaller body weight.

I was under the impression that 1g of Ceftriaxone a day was appropiate
for most infection and I would be grateful if anyone could provide me
with some evidence to support this view, or to educate me otherwise.

Thank you for your assistance.

Richard Duncan
Chief Pharmacist
Ministry of Health
Republic of Palau

P.O.Box 6027
Koror PW 96940



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