Is it possible to dilute Ceftriaxone with Novocaine for adults and children?

Action of Ceftriaxone

The drug is packaged in bottles of 0.5, 1 and 2 g of powder. Its solution is used for parenteral (intramuscular or intravenous) administration into the body for various bacterial infections:

• skin and soft tissues, including infection of wound surfaces;
• upper and lower respiratory tract;
• genitourinary system (including syphilis and gonorrhea);
• abdominal cavity, including some acute intestinal infections;
• osteoarticular system.

Ceftriaxone is used for intramuscular or intravenous administration.

The use of the drug is due to:

• wide spectrum of bactericidal action;
• penicillinase resistance;
• high concentration in biological fluids such as blood, synovial, spinal, peritoneal, etc.

Effect of Ceftriaxone on the body

The medicine is released in powder form. The prepared solution is injected into a muscle or vein.

• infectious diseases of the respiratory tract;
• skin pathologies;
• urinary tract diseases;
• venereal diseases;
• peritonitis;
• gynecological diseases.

After starting treatment, the patient’s symptoms decrease on day 2-3. Since the drug is made in powder form, it must be diluted with saline or painkillers - Lidocaine or Novocaine.

Indications for simultaneous use

The instructions for Novocain do not contain indications for using the drug as a solvent for antibiotics. Despite this, it is often used as an adjuvant for intramuscular injections of Ceftriaxone in adults, since the administration of an aqueous solution of the antibiotic causes local pain.

Novocaine is used as an adjuvant for intramuscular injections of Ceftriaxone.

Reviews

Reviews from doctors and people who have used these medications are good.

Doctors

Stepan, 49 years old, therapist, Nizhny Novgorod

I prescribe antibacterial agents with painkillers to my patients for various types of infections for intramuscular injections. If you dilute the medications correctly and take them according to the doctor’s instructions, the effect occurs quickly.

Konstantin, 44 years old, dermatologist, Omsk

For skin and bone infections, the antibiotic Ceftriaxone has proven itself to be excellent. But since its intramuscular administration is painful, I advise you to mix it with Lidocaine. It does not affect the action of the drug in any way, but plays only a short-acting analgesic role.

Methods of using Ceftriaxone and Novocaine

Ceftriaxone and Novocaine are used together only for intramuscular injections. It is advisable to mix the drugs immediately before injection, since the antibiotic retains its activity for no more than 6 hours at room temperature and no more than 24 hours in the refrigerator.

How to breed

To dilute 1 g or 500 mg of antibacterial powder, use the following proportions:

• 4-5 ml of Novocaine with an active ingredient content of 5 mg/ml;
• 2 ml of anesthetic containing 10 mg/ml and 2 ml of water for injection.

An anesthetic is drawn into a 5 ml syringe and injected into a bottle with an antibiotic. The syringe is disconnected, leaving the needle in the bottle. After vigorously shaking the bottle, the powder should completely dissolve. The resulting liquid is drawn into a new syringe. For injection, use another sterile needle.

If 500 mg of the drug is needed, but there are only bottles with 1 g, then for dilution use 2 times the volume of Novocaine. But after dilution, 5 ml of solution is again drawn into the syringe, which is injected intramuscularly.

How to prick

Injections are often given in the upper outer quadrant of the gluteal region. The needle is inserted deep into the muscle.

How to dilute Ceftriaxone, with what can you inject the antibiotic?

The use of antibacterial drugs forms the basis of treatment for various types of bacterial infections.

They act directly on the pathogen, slowing down its growth and development, causing destruction of cell walls and death. Among the well-known antibiotics is Ceftriaxone, which is available in powder form.

Before using the medicine, the question arises: how to dilute Ceftriaxone and with what to achieve maximum effect.

What is Ceftriaxone?

Antibiotic powder Ceftriaxone is a drug belonging to the group of third generation cephalosporins. The drug has a wide spectrum of action and is used for parenteral administration (into a vein or muscle).

Its bactericidal activity is due to the ability to suppress cell wall synthesis in bacteria. The product is highly effective against a large number of gram-negative and gram-positive bacteria and anaerobes.

This explains the wide scope of use of the antibiotic: the drug is used in various fields of medicine.

What does Ceftriaxone help with?

Without knowing exactly their diagnosis or the name of the disease, when prescribing medication, patients often ask a question regarding what Ceftriaxone injections help with.

The list of microorganisms against which the drug is effective is wide, so we will highlight the main types of diseases for which Ceftriaxone is used:

• infectious diseases of the abdominal organs: inflammation of the gastrointestinal tract, peritonitis, pathologies of the biliary tract, cholangitis;
• respiratory diseases: abscess, pneumonia, pleural empyema;
• infections of the musculoskeletal system: damage to joints, bones;
• diseases of the urogenital tract – both nonspecific and specific (gonorrhea);
• bacterial meningitis;
• endocarditis;
• sepsis;
• borreliosis;
• typhoid fever.

Is it necessary to dilute Ceftriaxone?

Treatment with Ceftriaxone involves preliminary preparation of a solution for injection. The drug is produced in the form of a white powder in bottles.

Before diluting Ceftriaxone to the required concentration, it is necessary to take into account the dosage of the drug prescribed by the doctor. Only after this the medicine can be used for intravenous or intramuscular administration.

The nurse determines how to properly dilute Ceftriaxone in a particular case, taking into account the site of administration of the drug.

How is Ceftriaxone diluted?

Even before the start of outpatient treatment with the drug, patients often have a question about how to dilute Ceftriaxone.

To obtain a solution, doctors use various sterile liquids and even drugs:

• water for injections;
• Novocaine;
• Lidocaine.

The latest medications are painkillers. Their use can reduce the pain experienced by the patient during the administration of the antibiotic and after the injection. It is worth noting that the choice of means for preparing the solution is determined by the place of administration of the prepared drug (intramuscular or intravenous).

When injected into a muscle, the maximum concentration of the active ingredient in the blood is observed after 1.5–2 hours, and when injected into a vein, immediately after the end of the procedure.

Having figured out what solutions can be used to prepare the medicine, you need to find out how to dilute Ceftriaxone.

Doctors, even before telling how Ceftriaxone injections are diluted directly for intramuscular administration, pay attention to the maximum dosage.

With this type of administration, it is allowed to use no more than 1 g of dissolved drug. To dilute the powder and prepare a solution, use water for injection and an anesthetic.

Each type of prepared solution has a number of features:

1. Ceftriaxone prepared in water for injection is not capable of causing allergic reactions. However, this solution causes severe pain when administered: the injection is administered very slowly, over 2-3 minutes.
2. To save the patient from suffering, Lidocaine and Novocaine are used as a solvent. However, these drugs often provoke anaphylactic shock, so they are used only in hospitals where emergency care is available.

How to dilute Ceftriaxone for intravenous administration?

When prescribing the drug Ceftriaxone, the use of the drug, elimination features, and dosage are determined individually by doctors. If the patient is being treated in a hospital, then preference is given to intravenous drip administration. In this form, the drug not only acts on the pathogen itself, but also helps rid the body of intoxication.

To prepare the solution and place the dropper, use water for injection. When asked by patients whether Ceftriaxone can be diluted in advance, doctors answer negatively.

The prepared solution is added to a system filled with glucose or saline solution. Nurses know how to dilute Ceftriaxone in this case, in addition, the information is duplicated in the doctor’s prescription sheet.

Lidocaine cannot be used to dilute the antibiotic.

Is it possible to dilute Ceftriaxone with saline?

When looking for a means to prepare a solution, patients often ask their doctor whether it is possible to dilute Ceftriaxone sodium chloride.

This substance is isotonic in concentration with respect to blood plasma, therefore it is often used for intravenous infusions. It can be used for dilution if the antibiotic is administered by drip.

If the drug is prescribed intravenously as a bolus (administered using a syringe), Ceftriaxone powder must be diluted with water for injection.

Doubting the admissibility of using anesthetics to prepare an antibiotic solution, patients often wonder whether Ceftriaxone can be diluted with Novocaine.

Doctors do not recommend using this drug as a solvent in a particular case. It has been established that Novocain can reduce the therapeutic effectiveness of the antibiotic.

In addition, there have been cases of fatal anaphylaxis when an antibiotic was administered with this drug.

Lidocaine is used as an alternative. It relieves pain several times better, in addition, allergic reactions when using this drug rarely occur. To prepare the solution, use a 1% lidocaine solution. How to dilute Ceftriaxone with this anesthetic is discussed below.

Wanting to know about all types of antibiotic solvents, patients ask the doctor whether Ceftriaxone can be diluted with Analgin. At the same time, they pursue the goal of reducing pain during the injection.

Doctors do not use Analgin to prepare solutions for parenteral administration. This drug has insufficient analgesic effect, so it is not advisable to use it.

Lidocaine is used as a solvent with a pronounced analgesic effect.

How to dilute the antibiotic Ceftriaxone?

Before injecting Ceftriaxone intramuscularly (intravenously), it is necessary to properly dilute the drug. To do this, you need to refer to the doctor’s prescription sheet, which details the dosage and frequency of administration of the medicine. The drug is available in bottles, sealed with a rubber cap and sealed with a metal ring.

The breeding algorithm itself is as follows:

1. The nurse treats the bottle cap with a cotton ball soaked in antiseptic.
2. Using a sterile syringe filled with a solvent (water, lidocaine), inject the solution into the bottle.
3. Mix thoroughly and shake the bottle until the powder is completely dissolved and a homogeneous solution is obtained.
4. Takes the solution from the bottle with another sterile syringe and injects it into the muscle (upper outer quadrant of the buttock) or intravenously, as prescribed by the doctor.

In order for the medicine to work correctly and quickly, you need to know exactly how to dilute Ceftriaxone with Lidocaine. To prepare the finished solution, use a 1% anesthetic solution. In this case, it is necessary to take into account the dosage prescribed by the doctor and the drug used. Ceftriaxone is available in 500 and 1000 mg doses, so you should be as focused as possible when diluting the antibiotic.

To prepare the required concentration of the active substance, you must adhere to the following schemes:

1. To obtain a solution with 0.5 g of Ceftriaxone, a bottle with a dosage of 500 is diluted with 2 ml of 1% Lidocaine (1 ampoule).
2. To obtain a solution of 0.5 g of antibiotic using a drug with a dosage of 1000 mg, dilute 4 ml of anesthetic and take 2 ml of the resulting solution for infection.

How to dilute Ceftriaxone with Lidocaine and water?

There is no point in talking separately about how to dilute Ceftriaxone with water for injection - the principle is the same as with Lidocaine discussed above. However, in some cases, doctors have to use an anesthetic and injecting water at the same time. This happens if you only have a 2% lidocaine solution on hand.

In such cases, proceed as follows:

1. 2 ml of water for injection and the same amount of lidocaine are taken into the syringe.
2. From the resulting volume of solution, 2 ml is used to dilute Ceftriaxone.

How to inject Ceftriaxone?

To get a quick effect from taking Ceftriaxone, the injection must be administered correctly. The place of administration of the antibiotic and the method are determined by the doctor. Doctors give preference to the intravenous method, as the fastest-acting. The elbow crease is often chosen as the injection site.

For mild infections, without complications or other associated pathologies, doctors can provide outpatient treatment. In such cases, the nurse explains to the patient in advance how to properly dilute Ceftriaxone and administer it intramuscularly.

The injection algorithm is as follows:

1. The drug is diluted according to the schedule established by the doctor.
2. The injection site and the gluteal muscle are treated with an antiseptic solution.
3. Visually dividing the buttock into 4 parts, the needle is inserted into the upper outer quadrant.
4. The solution is injected slowly, the needle is removed and a cotton ball is applied to the injection site.

Regardless of how Ceftriaxone will be administered, intramuscularly or intravenously, a test is performed to avoid a reaction to the use of an anesthetic (Lidocaine). It is done immediately before the injection in the treatment room.

A small volume of the drug is injected subcutaneously and the body’s reaction is observed:

1. If the injection site is not red, there is no burning or itching, the drug is well tolerated by the body.
2. If a reaction occurs, the drug is discontinued and an alternative drug is selected.

Ceftriaxone - dosage

When using Ceftriaxone with Lidocaine as the main treatment, doctors determine the dosage and frequency of the medication based on the collected data (severity of the disease, presence of concomitant pathologies). In this case, the type of disease is of decisive importance.

In general, doctors adhere to the following dosages:

• newborns (up to 2 weeks) – 20–50 mg per 1 kg of weight per day;
• infants and children under 12 years of age – 20–80 mg/kg per day, depending on the severity of the disease;
• adults and children over 12 years of age - 1-2 g once a day or 0.5-1 g twice every 12 hours (daily dose - no more than 4 g).

How long should I inject Ceftriaxone?

The main question asked by patients taking Ceftriaxone is how many days the antibiotic treatment lasts. Each case is individual, so only a doctor can correctly determine the required duration of therapy.

Doctors recommend using the medicine for two days from the moment the symptoms disappear and you feel better. The entire course of antibiotic treatment can last from 4 to 14 days. On average, 10 days pass from the start of treatment to recovery.

Source: https://womanadvice.ru/kak-razvodit-ceftriakson-s-chem-mozhno-kolot-antibiotik

Side effects

Both drugs can cause an allergic reaction: from skin manifestations to bronchospasm and anaphylaxis. Moreover, the likelihood of their occurrence increases with the combined use of drugs. Therefore, before prescribing antibiotics and local anesthetics, they find out the presence of any symptoms of intolerance in the anamnesis and conduct allergy tests.

Among other side effects, the most common local reactions are: redness and infiltration - compaction or “bump” at the injection site. Despite the use of an anesthetic, there may be pain during the injection. Less common side effects include:

• nausea, vomiting and dyspepsia;
• decreased blood clotting;
• cardiac dysfunction;
• instability of blood pressure;
• headache, motor or sensory disturbances, etc.

Treatment regimen

Usually the powder is mixed with an anesthetic right before injection. The finished suspension can be stored for up to 6 hours. Injections are given into veins or muscle tissue.

The daily dose for those over 12 years old or if the child weighs over 50 kg is 1-2 g. For complicated conditions, up to 5 g is given. The composition is administered once. You can give it twice a day with a 12-hour break, but then the required volume is divided in half. Before surgical interventions, 1-2 g of antibiotic is administered for prophylaxis 0.5-1.5 hours before opening.

For children less than 14 days old, the medication is given once a day. The dose is calculated as 20-50 mg per 1 kg. Children under 12 years of age are prescribed a dosage, taking into account their weight, but it is calculated based on 20-75 mg per kilogram.

If the prescribed volume is more than 50 mg per kg, then the drug is administered into a vein within 30-40 minutes.

The duration of the course is determined by the disease, as well as the characteristics of the clinical picture. For some, 4 days are enough for treatment, for others it takes 2 weeks.

Doctors' opinions on drug compatibility

Doctors using Ceftriaxone with Lidocaine have noted that allergic reactions rarely occur. Novocaine intolerance is more common, and it can be in the form of rapidly developing swelling of the face, neck, and deterioration in breathing, which requires urgent resuscitation measures. Therefore, when diluting an antibiotic, which itself provokes allergies, it is better to use Lidocaine.

If you are prone to intolerance to any medications or diseases with an allergic component (for example, bronchial asthma, seasonal rhinitis), a skin test before starting treatment is strictly required.

In what cases is Ceftriaxone contraindicated?

The doctor does not prescribe Ceftriaxone to patients with hypersensitivity to antibacterial agents of the cephalosporin group or to other components that make up the drug.

Doctors do not prescribe Ceftriaxone:

• a newborn baby with hyperbilirubinemia (increased levels of red blood cells);
• for the treatment of a premature baby;
• patients with renal or liver failure;
• during pregnancy and breastfeeding;
• patients diagnosed with enteritis (chronic polyetiological inflammatory disease of the small intestine) and colitis (inflammatory disease of the mucous membrane of the colon).

Ceftriaxone is not prescribed in case of known hypersensitivity to cephalosporin antibiotics or auxiliary components of the drug.

Relative contraindications:

• the neonatal period if the child has hyperbilirubinemia;
• prematurity;
• renal/liver failure;
• enteritis, UC or colitis associated with the use of antibacterial agents;
• pregnancy;
• lactation.

Basic information

Ceftriaxone is a 3rd generation antibiotic that can interfere with the synthesis of peptidoglycan in bacterial cell walls.
Externally, it is a fine-crystalline powdery product. The color of the composition is white or with a yellow tint. The bottles contain 0.25 g, 0.5 g, 1 g or 2 g. A solution for injections is obtained from the chemical composition or used for infusion therapy. The compound is 83-96% bound to blood proteins. The highest concentration is detected at the end of administration of the composition when infused into a vein and after 2-3 hours when administered intramuscularly.

Attention!

This drug is not combined with other antimicrobial medications. Ceftriaxone has a negative effect on the intestinal microflora and interferes with the production of vitamin K. Accordingly, simultaneous use with compounds that reduce platelet aggregation may result in bleeding. The drug also enhances the effect of taking anticoagulants. If loop diuretics are used simultaneously in therapy, nephrotoxicity may develop.

If a person is on hemodialysis or has a history of liver or kidney disease, plasma concentrations of Ceftriaxone should be monitored.

During a prolonged course, blood tests are taken to determine liver and kidney function indicators. If changes in fluid and electrolyte balance are observed in hypertension, monitor sodium.

Sometimes ultrasound of the gallbladder shows slight darkening. This indicates the presence of sediment, which goes away on its own at the end of the course.

For weakened people, it is sometimes advisable to simultaneously prescribe vitamin K. Ceftriaxone does not affect the quality of neuromuscular conduction.

Important! Drinking alcoholic beverages while undergoing antibiotic treatment is unacceptable due to the possibility of symptoms typical of severe poisoning. A fatal outcome cannot be ruled out.

Can there be an overdose?

An overdose of Ceftriaxone is possible when using high doses (above the maximum) and disruption of the kidneys and liver. It is manifested by nausea, vomiting, diarrhea, headache, dizziness. Convulsions may occur in young children. Overdose treatment is carried out only in a hospital. Droppers with infusion solutions and anticonvulsants are prescribed.

In case of drug overdose, side effects may increase:

• thrombocytopenia;
• fever;
• Gastrointestinal reactions;
• anorexia;
• stomatitis;
• hemolytic anemia.

Treatment: supportive and symptomatic therapy is provided. There is no specific antidote.

Properties of Lidocaine

Ceftriaxone powder must be dissolved before use. Since the drug is painful, the anesthetic Lidocaine, which also has an antiarrhythmic effect, is used together with it. The effect of pain relief is expressed in the inhibition of processes occurring in the nerve endings.

When an injection is administered, the highest effect of the anesthetic is possible after 5 minutes. Up to 80% of lidocaine is absorbed into the blood plasma, which quickly spreads throughout the body, penetrating the muscles, tissues of the heart, liver, kidneys, and lungs. Metabolism occurs 90% in the liver. With the participation of its enzymes, the period of partial elimination occurs after 2 hours. With liver dysfunction, the metabolic rate decreases to 10-50%. The drug is excreted in bile and urine.

The drug is indicated for use as the following types of anesthesia:

• infiltration (local anesthetic);
• conductive (blocks the transmission of impulses along the nerve node);
• spinal (introduced into the subarachnoid space);
• epidural (introduced into the epidural space of the spinal cord).

The use of Lidocaine is indicated:

• for stopping tachycardia;
• with myocardial infarction;
• during surgical interventions;
• as a prevention of ventricular arrhythmia;
• in acute coronary syndrome.

The use of lidocaine is indicated for myocardial infarction.

The use of lidocaine is indicated for the prevention of ventricular arrhythmia.

The use of Lidocaine is indicated for surgical interventions.

The use of lidocaine is indicated for stopping tachycardia.

The use of Lidocaine is indicated for acute coronary syndrome.