Self-administration of ceftriaxone

This leaflet is for patients who have been advised to take an antibiotic called ceftriaxone to treat their infections and have chosen to self-administer this medication with the support of the outpatient parenteral antibiotic team (OPAT).

What is ceftriaxone?

Ceftriaxone belongs to a group of antibiotics called cephalosporins. It is a medicine that can be used to treat a wide range of serious bacterial infections. Ceftriaxone will always be administered intravenously (into a vein) and must not be taken by mouth.

Are there any side effects?

The most common side effects, noticed by more than one in 100 patients and less than one in 10 patients are:

• headache
• diarrhoea, nausea, vomiting
• rash, itching

If you experience any of the above or any other side effects please inform one of the OPAT team. You will have regular blood tests in clinic while being treated with ceftriaxone to check for any problems.

How do I administer it?

The OPAT nurse and ward nursing team will ensure you are happy and safe to administer ceftriaxone following the procedure below.

Actions

Always remember to check the dose and the expiry date of ceftriaxone, water for injection and normal saline (sodium chloride).

1. Wash your hands and clean the preparation surface with large clinell wipes and
assemble the necessary equipment. Your preparation surface should be a non-
porous surface which is clear of clutter (eg a kitchen top or work desk).

2.Prepare sodium chloride 0.9% flushes

• Clean the top of the sodium chloride 0.9% ampoules with a small clinell wipe and allow 20 seconds to dry before opening them.
• Draw up the saline into a 10 millilitre (ml) syringe using a red needle. Remove the needle and dispose directly into the sharps bin.
• Remove any air from the syringe - tap the syringe with your finger or tap the side of the syringe on a clean surface to move air bubbles to the top. Do not touch the tip of the syringe.
• Return the filled syringe to the original packet to keep it clean.
• Repeat the above for the second flush with a new needle and syringe.

3. Prepare medication

• Clean the top of the ‘water for injection’ ampoules with a small clinell wipe and allow 20 seconds to dry before opening it.
• Draw up both the 10ml ‘water for injection’ ampoules into a 20 ml syringe using a red needle.
• Slowly inject all the water into the 2 gram (g) ceftriaxone vial and gently rock the vial until the medication is fully dissolved. Keep the needle and syringe attached to the vial.
• Withdraw all of the mixed solution into the syringe – tilt the vial to the side if necessary.
• Remove the needle from the syringe and put it into the sharps bin.
• Remove any air from the syringe - tap the syringe with your finger or tap the side of the syringe on a clean surface to move air bubbles to the top. Do not touch the tip of the syringe.
• Return the filled syringe to the original packet to keep it clean.

4.Administering the medication

• Clean the bio-connector on your PICC line with a small clinell wipe and allow 20 seconds to dry.
• Flush the line with 10ml of sodium chloride 0.9% solution using the ‘push-pause’ pulse technique as demonstrated by the ward nurses and OPAT team.
• Administer ceftriaxone via the syringe in a smooth continuous motion over five minutes. Ensure a clock or timer is used.
• Flush the PICC line with 10ml of sodium chloride 0.9% solution using the pulse technique.

Potential problems

You should let the OPAT team know if any of the following happen;

• You feel unwell after administering the antibiotic.
• The antibiotic or the flush cannot easily be administered through the PICC line.
• You may have injected a large amount of air.
• The PICC line feels sore/ uncomfortable, or a discharge is coming from the PICC entry site.

Contacts and additional information

OPAT specialist nurses

Monday to Friday 08:00 to 16:00: 01223 245151 and ask for the OPAT nurses.

Please note- The OPAT nurses are not available weekends or bank holidays.

After hours, weekends and bank holidays: 01223 245151 and ask for on-call infectious diseases registrar.