Can ceftriaxone be dissolved in glucose?

Under normal circumstances, ceftriaxone sodium should not be dissolved in glucose solution. Ceftriaxone, whose full name is ceftriaxone sodium, belongs to the third-generation cephalosporin antibiotics. It is routinely recommended to be diluted with saline, as glucose solution may affect the efficacy of ceftriaxone sodium; therefore, it is not advisable to dissolve ceftriaxone sodium in glucose. The detailed explanation is as follows:

Ceftriaxone sodium is an organic compound that exhibits strong activity against Escherichia coli, Klebsiella pneumoniae, indole-positive Proteus species, Haemophilus influenzae, Serratia species, Neisseria meningitidis, and Neisseria gonorrhoeae. Streptococcus pneumoniae, streptococci, and Staphylococcus aureus show moderate sensitivity to this drug, while Pseudomonas aeruginosa shows some susceptibility. Ceftriaxone sodium is a β-lactam antibiotic. Glucose injection has a pH value of 3.2–5.5, making it weakly acidic. In acidic environments, β-lactam antibiotics undergo hydrolysis due to opening of the β-lactam ring, leading to reduced potency and increased impurity levels. Therefore, dissolving ceftriaxone sodium in normal saline (which is nearly neutral) is preferred, as it better maintains the stability of the drug. Although many β-lactam antibiotic package inserts state that they can be prepared with either glucose or sodium chloride solutions, from a pharmaceutical chemistry standpoint, sodium chloride solution is more suitable. Clinically, unless patients have conditions requiring sodium restriction—such as congestive heart failure or renal insufficiency—these drugs are typically prepared with sodium chloride solution.

Ceftriaxone sodium should only be used when there is a clear clinical indication and under the approval of an infectious disease specialist or pulmonologist. Patients are advised to strictly follow their physician's instructions when taking this medication.