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Ceftriaxone bilirubin displacement — MRCPCH TAS MCQ

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ModeratePharmacologyCeftriaxone bilirubin displacementMRCPCH TAS

A jaundiced 3-day-old neonate needs parenteral antibiotics. A senior advises avoiding a third-generation cephalosporin that can displace bilirubin from albumin. Which drug is being avoided?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Ceftriaxone

Ceftriaxone can displace bilirubin from albumin and is generally avoided in neonates at risk of kernicterus. Cefotaxime is often preferred when a third-generation cephalosporin is needed in neonates. The teaching point is that protein binding can be clinically important when bilirubin levels are high.

Reference: BNFc; Nelson Textbook of Pediatrics; RCPCH Theory examination syllabi