03/10/25 Health Advisory: Report any serious adverse events after ceftriaxone administration

| March 10, 2025
2 IV bags hanging from an IV pole.

Summary

On Feb. 7, 2025, Centers for Disease Control and Prevention (CDC) issued a call for cases related to about 10 severe adverse events that closely followed ceftriaxone injection or infusion. The events began Sept. 1, 2024.

No single product type or lot number is tied to these severe events. While there is no confirmed causal link to ceftriaxone, a public health investigation is underway to identify and characterize the events.

Investigators have not identified any cases in Washington.

If you administer ceftriaxone, you should monitor closely for severe adverse events, be prepared to treat them immediately, and report them.

What you should do

Providers should be alert for these severe reactions and report them as described below. Washington State Department of Health (DOH) will share de-identified information with CDC about severe events. Report any severe adverse events that meet all the following criteria:

  • Severe reaction requiring cardiopulmonary resuscitation (CPR) or resulting in death;
  • And occurring within 6 hours of receipt of injectable ceftriaxone1 in a non-ICU setting;
  • And not attributed by the treating provider(s) to a cause other than ceftriaxone administration.2
  1. Including both intramuscular and intravenous administration. 
  2. Such as known infection, other underlying medical condition, or exposure to a medication or medical product other than ceftriaxone. 

How to report

  • How to report:
    • For cases dating back to Sept. 1, report to DOH:
      • Email: MDRO-AR@DOH.wa.gov.
      • Phone: (206) 418-5500.
      • Do not report cases of allergic reactions; only report severe events as described above.
    • Providers should also report severe adverse events associated with ceftriaxone, or any other drug or medical device, to FDA’s MedWatch program.
  • If your patient has a severe reaction, consider the following:
    • If there is any residual open product linked to a severe reaction, sequester the product for potential testing.
    • If no residual product is available, consider setting aside a sample of product from the same lot number for future testing.