The use of ceftriaxone in ambulatory patients

Twenty ambulatory patients, living in kibbutzim (communal villages, which have a permanent medical staff) were treated with ceftriaxone 1 g daily I.M. for ten days. These patients suffered from moderate to severe infections which were not life-threatening. Twelve had urinary tract infections (UTI), 3 of which were positive blood cultures. Four patients had soft tissue infections (one with a Group A beta-hemolytic Streptococcus bacteremia). Three patients had respiratory infections, and one elderly patient had Salmonella typhimurium gastroenteritis. All the patients in this series were clinically cured. Three patients with a UTI experienced reinfection. The woman with S. typhimurium gastroenteritis had persistent positive fecal cultures, but was asymptomatic. These 4 patients did not require further antibiotic therapy. The only side effect observed was mild diarrhea in one patient. Two other ambulatory patients with typhoid fever were treated with ceftriaxone 2 g daily I.V. for 10 days with excellent results. Our work showed that ceftriaxone 1 g daily can be a safe and inexpensive antimicrobial choice to shorten or prevent hospitalization.