Indications & Usage
• Acute bacterial Otitis media
• Treatment of infections of lower respiratory tract, skin and skin structures, bone and joint, and urinary tract 
• Treatment of pelvic inflammatory disease, intra-abdominal infections, gonorrhea (uncomplicated), meningitis, and septicemia caused by susceptible microorganisms; 
• Preoperative prophylaxis

Contraindications
• Hypersensitivity to cephalosporins; 
• Hyperbilirubinemic neonates (28 days or younger); 
• Concomitant use with calcium-containing IV solutions, including continuous calcium-containing infusions, such as parenteral nutrition in neonates; 
• Hypersensitivity to corn products (dextrose-containing solutions only)

Precautions & Warnings 
Because of the possibility of precipitation of Ceftriaxone calcium, do not administer IV ceftriaxone simultaneously with a calcium-containing IV solution or use diluents containing calcium to reconstitute or further dilute reconstituted ceftriaxone vials for IV administration. In patients other than neonates, ceftriaxone and calcium-containing solutions may be administered sequentially if infusion lines are thoroughly flushed with a compatible fluid between infusions. Also incompatible with vancomycin, amsacrine, aminoglycosides, and fluconazole; if coadministered with ceftriaxone, it is recommended that they be given sequentially with thorough flushing of the IV line. Ceftriaxone should not be mixed or piggybacked into solutions containing other antimicrobials.
Generally, therapy should be continued for at least 2 days after signs and symptoms of infection have disappeared. The usual duration of therapy is 4 to 14 days. In complicated infections, therapy may be longer.

Dosage 
Acute Otitis Media
Children: IM 50 mg/kg (max, 1 g) as a single dose. For cases that are persistent or treatment resistant, give the dose IV or IM for 3 days.
Infections
Adults: IV/IM 1 to 2 g once a day or in equally divided doses twice daily, depending on the type and severity of infection (max, 4 g/day).
Children: IV/IM 50 to 75 mg/kg/day in equally divided doses twice daily (max, 2 g/day).

Meningitis
Children: IV/IM Recommended initial dose is 100 mg/kg (max, 4 g), followed by 100 mg/kg once daily or in equally divided doses twice daily (max, 4 g/day) for 7 to 14 days.
Surgical Prophylaxis
Adults: IV 1 g as a single dose 30 min to 2 h before surgery.

Uncomplicated Gonococcal Infections
Adults: IM 250 mg as single dose.

Pelvic Inflammatory Disease (Mild to Moderate) (off-label)
Adults: IM 250 mg as a single dose with doxycycline 100 mg orally twice daily for 14 days, with or without metronidazole 500 mg orally twice daily for 14 days.

Renal/Hepatic Function Impairment
In patients with both hepatic impairment and renal disease, the dosage should not exceed 2 g daily.
Streptococcus pyogenes treatment should continue for at least 10 days.

Presentations 
AGEX-500 :  Injection, powder for solution 2g with sterile water