Ceftriaxone, sold under the trade name Rocephin, is an antibiotic useful for the treatment of a number of bacterial infections. This includes pneumonia, ear infections, skin infections, urinary tract infections, gonorrhea, pelvic inflammatory disease, sepsis, bone and joint infections, intra-abdominal infections, and meningitis. It is also used preoperatively to reduce the risk of postoperative infections. It is administered by intravenous or intramuscular injection. The most common side effects are related to route of drug administration, including pain at the site of intramuscular injection and thrombophlebitis in intravenous administration. Gastrointestinal upset is also common. Due to precipitation of ceftriaxone in bile, biliary sludging, gallstones, and cholecystitis are also possible, if less common. It should not be used in newborns due to the risks of bilirubin encephalopathy and ceftriaxone-calcium precipitation. Dosage adjustment is usually required in people with kidney failure. Caution should be used in those who have had serious allergic reactions to penicillin. It is a third-generation cephalosporin. Like other third-generation cephalosporins, it has broad-spectrum activity against Gram-positive bacteria and expanded Gram-negative coverage compared to second-generation agents. In most cases, it is considered to be equivalent to cefotaxime in terms of spectrum of antibacterial activity. Ceftriaxone sodium is marketed by Hoffmann-La Roche. It is on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system.