Ceftriaxone gonorrhea IV vs IM

[storyhill]

CDC has recently updated their gonorrhea ceftriaxone from 250 mg IM to 500 mg IM. At no point in the guidance does it discuss giving it via IV. I have seen the product information packet where serum concentrations are compared and after 4 hrs it looks quite similar. It seems to me that IV can be used as a route. I also saw a few emergency medicine podcasts that supported the idea of giving it IV if patient has IV access. Does anyone know if the CDC has any comments about this issue? Why are your thought on just giving IV if they have IV access. I work in the ED and encounter this sometimes. I am thinking CDC put IM as route just because in most setting patients don't have IV access, but am not 100% sure. Thanks.

---

Members don't see this ad.

 

[Rockinacoustic]

I'm not opposed to giving IV if the patient already has access, but would recommend at least 1gm (which typically has already been given for PID or another presumed GU issue)

 

[sadface]

Think I did 2g iv in the past but not sure if there are official recommendations

 

[njac]

If they have a line we give it IVP. The RNs who get perverse joy from giving punitive IM ceftriaxone don’t love it but that’s a much larger issue I don’t know if we’ll ever overcome.

I won’t have them place a PIV just for ceftriaxone.

 

[storyhill]

thanks for the input. I think maybe just giving 1 gm IV might be a decent idea just to be sure you get the right concentration. I wish the CDC would be more thorough in their recommendations.