Concomitant Ceftriaxone and Intravenous Calcium Therapy in Infants

OBJECTIVE To determine if increased mortality could be detected with the administration of ceftriaxone and IV calcium in infants through an analysis of a large repository of electronic health records. METHODS Patients were split into 3 groups: 1) neonates, 2) infants, and 3) infants RESULTS A total of 259,149 infants were identified. Of 79,038 neonates, the proportion of patients that received ceftriaxone and IV calcium within 48 hours who died was 3.8%, compared with 1.95% (IV calcium), 0.3% (ceftriaxone), 1.54% (IV fluids), and 2.03% (parenteral nutrition). For 102,456 infants, the proportions of deaths were 5.47% (ceftriaxone and IV calcium within 48 hours), 0.45% (IV calcium), 0.15% (ceftriaxone), 0.39% (IV fluids), and 5.5% (parenteral nutrition). Multivariate analysis showed increased odds of death in infants who received ceftriaxone and IV calcium within 48 hours, regardless of age, and propensity score–matched analysis showed a more than 2-fold increased risk for death. CONCLUSIONS The increased risk for death following ceftriaxone and IV calcium administration was noted not only in neonates, but among older infants as well.