Ceftriaxone Use in Pregnancy

Safety and Efficacy

• The Centers for Disease Control and Prevention (CDC) states that data are insufficient to recommend ceftriaxone for treatment of maternal infection and prevention of congenital syphilis 1
• The CDC recommends that penicillin remains the only proven effective treatment for preventing maternal transmission to the fetus and treating fetal syphilis infection 2, 3
• Pregnant women with penicillin allergy should undergo desensitization and receive penicillin rather than alternative agents, as recommended by the CDC 1, 2, 4, 5

Clinical Considerations

• There is a potential risk of cross-reactivity with penicillin allergy, although the risk is generally low, according to the CDC 6
• For neurosyphilis in HIV-infected pregnant patients, some specialists suggest ceftriaxone 1-2g IV daily for 10-14 days, but this remains based on limited observational data, as reported by the CDC 3