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Related Experiment Video

Updated: Oct 18, 2025

Treatment with Vancomycin Loaded Calcium Sulphate and Autogenous Bone in an Improved Rabbit Model of Bone Infection
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Concomitant Ceftriaxone and Intravenous Calcium Therapy in Infants.

Michael L Christensen, Parya Zareie, Bhavya Kadiyala

    The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
    |September 30, 2021
    PubMed
    Summary

    Concurrent administration of ceftriaxone and IV calcium in infants was associated with increased mortality. This risk was observed in both neonates and older infants, highlighting a critical safety concern.

    Keywords:
    adverse effectscalciumceftriaxoneelectronic health recordinfantmortality

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    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.