{"id":351,"date":"2009-04-18T06:15:37","date_gmt":"2009-04-18T11:15:37","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=351"},"modified":"2009-04-18T06:15:37","modified_gmt":"2009-04-18T11:15:37","slug":"ceftriaxone-and-calcium-ok-again-in-adults","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/ceftriaxone-and-calcium-ok-again-in-adults\/2009\/04\/18\/","title":{"rendered":"Ceftriaxone and Calcium &#8212; OK Again in Adults!"},"content":{"rendered":"<p>As every house officer, hospitalist, intensivist, and ID doc knows, ceftriaxone and calcium have been <a href=\"http:\/\/www.fda.gov\/cder\/drug\/InfoSheets\/HCP\/ceftriaxone.htm\" target=\"_blank\">contraindicated<\/a> since 2007 due to fears of a potentially fatal precipitation of the two that led to the death of 5 neonates.<\/p>\n<p>Pediatricians are fond of saying &#8220;kids are not small adults&#8221; (<a href=\"http:\/\/www.hydeparkpedi.com\/sax.html\" target=\"_blank\">I should know<\/a>), and if that&#8217;s true, it&#8217;s even more so that &#8220;neonates are not really <em>really <\/em>tiny adults.&#8221;<\/p>\n<p>So it&#8217;s not surprising that follow-up in vitro studies have shown that this is unlikely to be a problem when the drugs are administered sequentially.\u00a0 It&#8217;s also not surrising since no case of this fatal ceftriaxone\/calcium precipitation had <em>ever <\/em>occurred in adults, even though ceftriaxone has been one of the most commonly-given antibiotics on the planet for decades.<\/p>\n<p><a href=\"http:\/\/www.fda.gov\/CDER\/DRUG\/InfoSheets\/HCP\/ceftriaxone042009HCP.htm\" target=\"_blank\">But now we can give them to the same patient again<\/a>, so long as the person is older than 28 days, and ceftriaxone and calcium are administered sequentially.<\/p>\n<p>Hooray.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As every house officer, hospitalist, intensivist, and ID doc knows, ceftriaxone and calcium have been contraindicated since 2007 due to fears of a potentially fatal precipitation of the two that led to the death of 5 neonates. Pediatricians are fond of saying &#8220;kids are not small adults&#8221; (I should know), and if that&#8217;s true, it&#8217;s [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,7],"tags":[72,132,173,348],"class_list":["post-351","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-misc","tag-antibiotics","tag-calcium","tag-ceftriaxone","tag-fda"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/351","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=351"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/351\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=351"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=351"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=351"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}