IBRAIMI, Qahil and DAUTI, Merita and DURMISHI, Erëza and YZAIRI, Drita and ALIJA, Gjylaj and SELMANI, Driton (2026) CEFTRIAXONE AS AN EMPIRIC ANTIBIOTIC: PRESCRIBING PRACTICES, RESISTANCE DYNAMICS, AND STEWARDSHIP STRATEGIES. In: INTERNATIONAL CONFERENCE “FROM RESEARCH TO APPLICATION”, 20 May, 2026.
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Abstract
Ceftriaxone, a broad-spectrum third-generation cephalosporin, is widely used as empiric antibiotic therapy for severe infections, including pneumonia, sepsis, and complicated urinary tract infections [1,2]. Its clinical relevance is supported by favorable pharmacokinetics, broad antimicrobial activity, and convenient once-daily dosing. However, increasing global use has been accompanied by a significant rise in antimicrobial resistance, particularly mediated by extended-spectrum β-lactamases (ESBL), AmpC β-lactamases in Gram-negative bacteria, and penA mutations in Neisseria gonorrhoeae [3,4]. These developments raise concerns regarding the continued effectiveness of ceftriaxone in empiric treatment. This study aimed to evaluate the rational use of ceftriaxone in empiric therapy and its relationship with resistance development. The importance of this paper lies in addressing the growing gap between widespread ceftriaxone use and evidence-based prescribing, which directly contributes to antimicrobial resistance, increased healthcare burden, and compromised patient outcomes. Ceftriaxone was selected as the model antibiotic due to its global prevalence, well-characterized pharmacological profile, and central role in clinical guidelines for empiric therapy. The rationale was supported by evidence of substantial inappropriate use [5-7]. Common empiric indications included community-acquired pneumonia, sepsis, febrile neutropenia, complicated urinary tract infections, meningitis, and surgical prophylaxis. Standard dosing ranged from 1-2 g intravenously every 24 hours [2,8], with shorter treatment durations demonstrating comparable efficacy to prolonged regimens [9]. Evidence indicates that ceftriaxone remains effective when resistance risk is low, however, routine overuse is strongly associated with resistance. A multicenter surveillance study reported approximately 28% resistance among Enterobacterales isolates [3]. Higher dosing (2 g) rarely improves outcomes compared to 1 g in most infections [8,7], except in selected critically ill patients. Antimicrobial stewardship strategies, including restriction policies, de-escalation, and IV-to-oral conversion, have demonstrated effectiveness in reducing inappropriate use [12]. Current evidence supports reserving empiric ceftriaxone for well-defined indications and avoiding its use when local resistance exceeds 10-20% [13].
| Item Type: | Conference or Workshop Item (Paper) |
|---|---|
| Subjects: | Q Science > Q Science (General) |
| Divisions: | Faculty of Law, Arts and Social Sciences > School of Social Sciences |
| Depositing User: | Unnamed user with email zshi@unite.edu.mk |
| Date Deposited: | 10 Sep 2026 14:08 |
| Last Modified: | 10 Sep 2026 14:08 |
| URI: | http://eprints.unite.edu.mk/id/eprint/2408 |
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