Amoxicillin vs. Ceftriaxone

Amoxicillin is a penicillin-type antibiotic that stops bacteria from multiplying by preventing them from forming protective cell walls. It is effective against many different bacteria, including H. influenzae, E. coli, Pneumococci, N. gonorrhoea, Streptococci, and some strains of Staphylococci. Amoxicillin is used to treat bacterial infections of the middle ear, tonsils, throat, larynx (laryngitis), lungs (pneumonia), bronchi (bronchitis), urinary tract, and skin. It is also used to treat gonorrhea.

Ceftriaxone is a cephalosporin antibiotic used to treat various bacterial infections such as lower respiratory tract infections, skin and skin structure infections, urinary tract infections, pelvic inflammatory disease, bacterial septicemia, bone and joint infections, and meningitis. It works by stopping the growth of bacteria.

Side effects of amoxicillin and ceftriaxone

Amoxicillin

Side effects of amoxicillin include:

People allergic to cephalosporin antibiotics may or may not be allergic to penicillins.

Serious but rare reactions include:

• seizures,
• severe allergic reactions (anaphylaxis), and
• low platelet (thrombocytopenia) or red blood cell count.

Amoxicillin can alter the normal bacteria in the colon and lead to overgrowth of bacteria such as Clostridium difficile, which causes inflammation of the colon (pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting amoxicillin (diarrhea, fever, abdominal pain, and possibly shock) should contact their physician immediately.

Ceftriaxone

You should not use this medicine if you have ever had a severe allergic reaction to ceftriaxone or any other cephalosporin antibiotic. Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Call your doctor at once if you have:

• a seizure (convulsions);
• severe stomach pain, watery or bloody diarrhea;
• sudden weakness or ill feeling, fever, chills, cold or flu symptoms, mouth sores;
• pale or yellowed skin, dark colored urine;
• severe pain in your upper stomach that comes and goes or spreads to your back;
• a blood cell disorder–skin rash or tight feeling, severe tingling or numbness, pain, muscle weakness; or
• kidney or bladder problems–pain in your side or lower back spreading to your groin, blood in your urine, painful or difficult urination, little or no urine.

Common side effects may include:

• mild diarrhea;
• warmth, tight feeling, or a hard lump where the injection was given;
• vaginal itching or discharge;
• rash; or
• abnormal liver function tests.

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Dosage of amoxicillin vs. ceftriaxone

Amoxicillin

• For most infections in adults, the dose of amoxicillin is 250 mg every 8 hours, 500 mg every 8 hours, 500 mg every 12 hours, or 875 mg every 12 hours, depending on the type and severity of infection.
• For the treatment of adults with gonorrhea, the dose is 3 g as a single dose.
• For most infections, children older than 3 months but less than 40 kg are treated with 25 or 45 mg/kg/day divided every 12 hours or 20 or 40 mg/kg/day with one-third of the daily dose every 8 hours, depending on the type and severity of the infection.
• Amoxicillin can be taken with or without food.

Ceftriaxone

• The usual adult daily dose is 1 to 2 grams once a day or in equally divided doses twice a day, depending on the type and severity of infection. The total daily dose should not exceed 4 grams.
• Ceftriaxone is injected into a muscle or into a vein through an IV.
• A healthcare provider will administer this injection when ceftriaxone is used to prevent infection from surgery.
• If you are instructed to use an IV at home to treat an infection, do not do so unless you fully understand how to use the injection and properly dispose of needles, IV tubing, and other items used.
• Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Drug interactions with amoxicillin and ceftriaxone

Amoxicillin

Amoxicillin is rarely associated with significant drug interactions.

Ceftriaxone

Rocephin must not be administered simultaneously with calcium-containing IV solutions, including continuous calcium-containing infusions such as parenteral nutrition via a Y-site. However, in patients other than neonates, Rocephin and calcium-containing solutions may be administered sequentially if the infusion lines are thoroughly flushed between infusions with a compatible fluid.

Other drugs may interact with ceftriaxone, including prescription and over-the-counter medicines, vitamins, and herbal products. Inform your doctor about all your current medicines and any medicine you start or stop using.

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Are amoxicillin and ceftriaxone safe to use while pregnant or breastfeeding?

Amoxicillin

• Penicillins are generally considered safe for use by pregnant women who are not allergic to penicillin.
• Small amounts of amoxicillin may be excreted in breast milk and may cause diarrhea or allergic responses in nursing infants. Amoxicillin is generally considered safe to use while breastfeeding. It is used to treat infections in newborns.

Ceftriaxone

• Reproductive studies in mice and rats have shown no evidence of harm at doses up to 20 times the usual human dose. In primates, no harm to embryos or fetuses was demonstrated at a dose approximately 3 times the human dose.
• No adequate and well-controlled studies have been conducted in pregnant women. This drug should be used during pregnancy only if clearly needed.
• Low concentrations of ceftriaxone are excreted in human milk. Caution should be exercised when Rocephin is administered to nursing women.

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Summary

Amoxicillin (Amoxil) and ceftriaxone (Rocephin) are antibiotics used to treat bacterial infections of the middle ear, tonsils, throat, respiratory tract, urinary tract, and skin. Amoxicillin is also used to treat gonorrhea. Ceftriaxone is also used to treat pelvic inflammatory disease, bacterial septicemia, bone and joint infections, and meningitis.