Ceftriaxoneis a third-generation cephalosporin with a Long half-life and acts against gram-negative and gram-positive bacteria. About 50% - 60% of the drug is excreted unchanged in urine, and the remaining 20% -40% is excreted in biLe,also unchanged. In patients with renaldysfunction, biliary elimination isincreased slightly (1). Thus, in patients with chronic kidney disease, dosage of this drug does not need to be reduced, provided liver function remains normal, and vice versa in cases with hepatic dysfunction. Tolerance for this antibiotic is usually good, but several adverse effects have been reported, including diarrhea, rash, thrombocytosis, thrombocytopenia, eosinophilia, elevated liver enzymes, renal stones, and hemolytic anemia. With respect to the hepatobiliary side effects, it has been reported that ceftriaxone can complex with the calcium in bile salts to form a precipitate that appears as biliary sludge or gallstones on ultrasound.
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