Key Messages:
1. ADPH is investigating eleven reports of potential adverse events after injections of
ceftriaxone that have occurred in the last few months in Alabama.
2. At this time, no causal link has been found, but ADPH is continuing to review any
additional reports.
3. Providers are urged to discuss the use of ceftriaxone with patients as a therapeutic and
have a plan in place to respond to any adverse events.
4. Providers should report potential adverse events related to ceftriaxone to ADPH at the
link below:
https://redcap.link/AdverseEventReport
Additionally, adverse events may be reported to FDA MEDWATCH:
https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-eventreporting-program
MONTGOMERY-ADPH, in collaboration with CDC’s Division of Healthcare Quality Promotion, is investigating
eleven reports, which have occurred in the last few months, of adverse events following
injections with the cephalosporin antibiotic ceftriaxone (Rocephin®). Persons investigated have
had a variety of comorbid conditions and no specific causal link between ceftriaxone and these
reactions has been identified at this time.
Out of an abundance of caution, ADPH will continue to collaborate with healthcare partners to
investigate the possibility of epidemiologic links between these events or in connection to receipt
of injections of this antibiotic, related diluting substances, or steroid medications often
administered in conjunction with antibiotics in healthcare settings.
Some of the cases reviewed have had signs and symptoms compatible with anaphylactic
reaction, including hives, pruritis, hypotension, and hypoxia, which have been successfully
treated with measures for anaphylaxis.
While this investigation is ongoing, it is important to keep in mind that, as with any injectable
antibiotic, allergic reactions can occur, and measure should be taken to monitor and respond
appropriately to such reactions. Cephalosporins, such as ceftriaxone, can cause allergic reaction
between 0.5% to 2.5% of patients. See the links below to American Academy of Allergy,
Asthma, and Immunology.
https://www.aaaai.org/Aaaai/media/Media-LibraryPDFs/Allergist%20Resources/Statements%20and%20Practice%20Parameters/Drug-Allergy2022.pdf
https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Para
meters/Practical-Guidance-for-the-Evaluation-and-Management-of-Drug-Hypersensitivity2020.pdf
https://www.aaaai.org/Aaaai/media/Media-LibraryPDFs/Allergist%20Resources/Statements%20and%20Practice%20Parameters/AnaphylaxisPractice-Paramaters-2023.pdf
ADPH will continue to act to promote and protect the health of the citizens of Alabama by
investigating, responding, and updating information accordingly.
Media Release/Alabama Department of Public Health