Ceftriaxone is a broad spectrum antibiotic that can be given by injection. It’s used to treat many different types of bacterial infections in children and is sometimes called by the brand name Rocephin. It belongs to the cephalosporin family of antibiotics (“cousins” to the penicillins). This antibiotic is only given as a shot or in an IV: it does not come in an oral form.

Ceftriaxone is a recommended first antibiotic for some children with severe ear infections who are allergic to amoxicillin and who have a high fever or severe ear pain. A child might receive one shot or three shots (one a day). Three daily shots might also be recommended as a stronger choice for a child who still has symptoms after 48 to 72 hours of another antibiotic, especially if there is a fever or severe ear pain.

If your child is given ceftriaxone for an ear infection, you should expect improvement within 48 to 72 hours. If not, contact your doctor to discuss more ceftriaxone shots, switching to another antibiotic, or draining the fluid in the ear.

Do Not use ceftriaxone if your child is known to be allergic to this or to any of the cephalosporin antibiotics, such as cephalexin, cefuroxime, or cefdinir. Other antibiotic options include amoxicillin-clavulanate or clindamycin. Be sure the prescribing doctor knows if your child has any other medication allergies (especially to penicillins), or has kidney disease, liver disease, intestinal problems, or gallbladder disease. Be sure to report any other medicines your child might be taking.

Diarrhea is a common side effect of antibiotics. Whenever antibiotics are given, consider also giving your child probiotics (beneficial bacteria). Out of ten well-designed studies, nine showed significantly less diarrhea in the children receiving probiotics (the studies used between 5 and 40 billion cfu per day). Probiotics are available as supplements or in some foods and beverages (yogurt, kefir, juice). Whatever you choose, look for at least 5 billion colonies.

Get emergency care if your child is showing signs of a serious allergic reaction, such as difficulty breathing, spreading hives, or swelling of the lips, tongue, or throat.

Other side effects are possible with this or any medication. Be sure to report unexpected new symptoms to your healthcare provider. Whether they are caused by the antibiotic or by the illness getting worse, unexpected symptoms are important to report.

AAP Clinical Practice Guideline. Diagnosis and management of acute otitis media. Pediatrics, May 2004, 113(5):1451-1465.

Johnston BC, Supina AL, Ospina M, Vohra S. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD004827. DOI: 10.1002/14651858.CD004827.pub2.

Published on: June 18, 2009
About the Author
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Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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