Concomitant Ceftriaxone and Intravenous Calcium Therapy in Infants

Area of Science:

• Pediatric pharmacology
• Clinical toxicology
• Health informatics

Background:

• Ceftriaxone is a common antibiotic used in infants.
• Intravenous (IV) calcium is frequently administered to neonates and infants.
• Potential interactions between ceftriaxone and IV calcium require investigation.

Purpose of the Study:

• To analyze electronic health records for mortality risks associated with ceftriaxone and IV calcium co-administration in infants.
• To determine if a statistically significant increase in mortality can be detected.

Main Methods:

• Retrospective analysis of a large electronic health record database.
• Categorization of patients into neonates and infants.
• Classification of deaths based on the timing and co-administration of ceftriaxone and IV calcium.
• Crude death rate calculation and logistic regression for adjusted odds of death.

Main Results:

• Analysis of 259,149 infants revealed higher mortality rates in those receiving ceftriaxone and IV calcium within 48 hours.
• For neonates, the death proportion was 3.8% with co-administration versus lower rates for single agents or other treatments.
• For infants, the death proportion was 5.47% with co-administration.
• Multivariate and propensity score-matched analyses indicated a more than 2-fold increased risk of death.

Conclusions:

• Ceftriaxone and IV calcium co-administration is linked to increased mortality in infants.
• This elevated risk is present in both neonates and older infants.
• Findings underscore the need for caution when administering these agents concurrently.