A neonate being considered for empiric sepsis therapy must not receive ceftriaxone. The specific reason for avoiding ceftriaxone in neonates is:

• A It precipitates renal failure through crystal nephropathy
• B It causes dose-dependent irreversible ototoxicity
• C It inhibits cartilage development in weight-bearing joints
• D It displaces bilirubin from albumin and risks kernicterus ✓

Explanation

Ceftriaxone is highly protein bound and displaces bilirubin from albumin, raising free bilirubin and risking kernicterus in the neonate whose blood-brain barrier is immature, so it is contraindicated in neonates, especially jaundiced or hypoalbuminemic ones. Cartilage toxicity is the fluoroquinolone concern, ototoxicity belongs to aminoglycosides, and crystal nephropathy is a recognized adult issue with high-dose ceftriaxone but is not the neonatal contraindication examined here.

Reference: Nelson Textbook of Pediatrics, 22nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.