Pharmacokinetics and Pharmacodynamics of High Dose Ceftriaxone in Patients With Sepsis

As the general treatment method for infectious diseases is to prescribe antibiotics which can be complete at the empirical treatment with the control of the sources of infection, the types of antibiotics that contain the broad spectrum and the proper dose to reduce the severity of infection play an important role. Especially, patients with sepsis should receive antibiotics within 1 hours after the diagnosis since the delay of 1 hour will decrease the rate of survival by 7.6 percent. Ceftriaxone is considered to be Cephalosporin, the antibiotics in the group of β-lactams antibiotic which kills bacteria by preventing the creation of significant cell walls. Ceftriaxone is soluble and can be excreted by the kidney. It is a β-lactams broad spectrum which can kill bacteria broadly including various types of gram-positive and gram-negative. The effectiveness of Ceftriaxone is in accord with the percentage of time that the level of the drug is beyond the minimum inhibitory concentration. According to the research in animals conducted by Craig WA and others, the drug effect to prevent the bacteria growth will occur when the %ft>MIC is more than at least 40%. The rate of prevention will reach the maximal bactericidal effect when the %ft>MIC is equal to 60 to 70%. At the moment, physicians prefer the 60 to 70% of %ft>MIC in the group of Cephalosporins drugs as the main pharmacodynamics to cope with infections.

Study Overview

• Status: Completed
• Conditions: Sepsis

• Study Type: Observational
• Enrollment (Actual): 20

Contacts and Locations

Study Locations

• Thailand
  • Changwat Songkhla
    • Hat Yai, Changwat Songkhla, Thailand, 90110
      • Faculty of Medicine, Prince of Songkla University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

20 people in total

Description

Inclusion Criteria:

• Participants aging over 18 years old with the symptoms of systemic inflammatory response syndrome (SIRS) which requires at least two of the following symptoms
• Temperature over 38 degree Celsius (Fever) or lower than 36 degree Celsius (hypothermia)
• Tachycardia
• Tachypnea, or the detection of PaCO2 under 32 mmHg, or hypocapnia due to hyperventilation
• Participants are about to received Ceftriaxone by the physician
• Weighting equal to or more than 50 kg

Exclusion Criteria:

• Patients with the clinical record of the severe allergy to β-lactam or Ceftriaxone
• Patients received Ceftriaxone within 3 days before the participation
• Having a culture result of being resistant to Ceftriaxone
• Having CLcr lower than 50 ml/min, or receiving hemodialysis, or renal replacement therapy
• Meningitis patients
• Decompensated liver disease
• Pregnant and lactating
• Septic shock patients
• Having the level of serum albumin lower than 2.5 g/dl

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Probability of target attainment of the pharmacodynamic index fT>MIC ≥ 100% for ceftriaxone	The percentage of simulated patients achieving the pharmacodynamic target of free drug time above MIC (fT>MIC ≥ 100%), estimated using population pharmacokinetic modeling incorporating observed plasma concentration-time data and pathogen-specific MIC values or reference MIC distributions.	First 24 hours of ceftriaxone treatment

Collaborators and Investigators

• Sponsor: Prince of Songkla University
• Investigators: Principal Investigator: Sarunyou Chusri, M.D., Ph.D., Prince of Songkla University

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2024
• Primary Completion (Actual): January 31, 2025
• Study Completion (Actual): February 28, 2025

Study Registration Dates

• First Submitted: February 21, 2025
• First Submitted That Met QC Criteria: November 17, 2025
• First Posted (Actual): November 24, 2025

Study Record Updates

• Last Update Posted (Actual): November 24, 2025
• Last Update Submitted That Met QC Criteria: November 17, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Infections; Systemic Inflammatory Response Syndrome; Inflammation; Pathological Conditions, Signs and Symptoms; Sepsis
• Other Study ID Numbers: REC.66-477-14-1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The data will remain anonymized.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No