BACKGROUND. Community-acquired bacterial meningitis (CABM) is a life-threatening condition that is common among immunocompromised
individuals. Intravenous ceftriaxone, of which Rocephin (ROC) is the originator brand, is recommended as first-line therapy in South
Africa. Despite concerns regarding therapeutic equivalence with generic agents, this is the first study that has been conducted comparing
clinical pharmacokinetics (PK) of a generic ceftriaxone formulation with the originator.
OBJECTIVE. To compare the PK and safety of Aspen Ceftriaxone (AC) and ROC in the treatment of adult CABM.
METHODS. A total of 63 eligible patients were randomised 1:1 to receive 2 g of either medication twice daily for a duration based on the
identity of the causative organism and their physician’s clinical judgment. The primary endpoint of this study was the comparison of clinical
PK, specifically the concentrations of each drug in the cerebrospinal fluid with corresponding paired plasma samples. While this study was
underpowered to assess efficacy, safety could be evaluated on the basis of reported adverse events.
RESULTS. The two patient groups were epidemiologically similar. There were no statistically significant differences in PK between either agent,
nor any difference with regard to safety.
CONCLUSION. AC can be considered as equivalent to ROC with regard to PK and safety in patients with CABM.