Subcutaneous Ceftriaxone***

Taking the PICC out of Parenteral Antibiotic Treatment

Ceftriaxone is the most widely used injectable beta-lactam for serious infection, with approximately 30 million doses administered annually in the US alone. It owes its widespread use to two characteristics: an excellent antibiotic spectrum and a long half-life.

Ceftriaxone is used in a broad range of infections, from middle-ear infections to diabetic foot ulcers. Common infections for which ceftriaxone is used are:

  • Skin and soft tissue infections – including a broad range of wound infections that can occur after an injury, surgery or because of an underlying condition such as diabetes
  • Bone and joint infections – similar to skin and soft tissue infections, there is a broad range of infections that may occur after surgery or an accident
  • Chest infections, including certain cases of pneumonia
  • Kidney and urinary tract infections
  • Pelvic and abdominal infections
  • Middle ear infections 
  • Infections in the blood stream
  • Surgical prophylaxis
  • Lyme’s disease

The Half-Life Advantage

The half-life of ceftriaxone ranges from 5.8 to 8.7 hours, so there are typically blood levels after 24 hours. Many other cephalosporins have a half-life of 0.5 to 2.5 hours and must be given multiple times a day.

Cephalosporins such as ceftriaxone must be maintained at minimum inhibiting concentration (MIC) for at least 4 days to treat an infection, and often for 2 to 3 weeks. For some infections, such as Lyme’s disease, treatment can be as long as three months.

Choices in Administration

Because treatment of serious infections often starts in the hospital, ceftriaxone can be administered via IV catheter. However, after discharge, patients have had to either accept painful intramuscular injections in a home care setting (typically not recommended) or transition to a peripherally inserted central catheter (PICC) with its risk of both serious and merely bothersome complications.

Now, scPharmaceuticals is working towards making ceftriaxone available for the first time for subcutaneous use, dispensed with its sc2Wear™ Infusor

 UPDATE: On March 2, 2016, the company announced the pivotal trial results of its second program – Subcutaneous Ceftriaxone for Treatment of Bacterial Infections. The results indicated antibacterial coverage equivalent to coverage following standard intravenous administration. Subcutaneous delivery represents a novel route of administration free from common and serious risks associated with intravenous infusion lines and deep intramuscular injections. Please click here to read the full release.


Mean Plasma Concentration (mcg/mL)

GROUP T2h T4h T6h T8h T12h T24h
1G Subcutaneous 56 72 62 53 37 13
2G Subcutaneous 86 123 104 90 61 21
1G Intravenous 84 62 49 41 28 10
From Package Insert
Intravenous 1G 88 67 53 43 28 9
Intramuscular 1G 76 68 56 44 29 ND

Potential Benefits of Ceftriaxone for Subcutaneous Delivery:

  • Greater flexibility as to where and by whom ceftriaxone can be administered
  • Avoidance of need for PICC placement
  • Reduced cost of care
  • Greater convenience and comfort

Subcutaneous ceftriaxone with the sc2Wear™ Infusor can be administered in the home setting by a healthcare professional, or by the patient or caregiver, freeing the patient from the clinical setting. It represents the first true advance in ceftriaxone treatment in more than 30 years.

Reference:

***Subcutaneous ceftriaxone is not approved for use in the United States.