Nurses should be aware of a revised warning concerning the third-generation cephalosporin antibiotic ceftriaxone (Rocephin). Because of case reports of the deaths of neonates who have received IV ceftriaxone concurrently with various IV solutions containing calcium, the product label now states that the drug should not be mixed with such solutions. Nor should it be administered by either the same or different infusion lines or at the same or different sites within 48 hours of the infusion of any such solution, including lactated Ringer's solution and parenteral nutrition. Precipitates were found to have formed when ceftriaxone had been mixed or reconstituted with solutions containing calcium for IV administration, but administration of the drug and a calcium solution at different times and even through different IV lines has also been found to create crystalline formations in the renal and pulmonary vessels, formations that have caused death in neonates. Although there are no reports of the drug interaction occurring in older patients, it's believed that it could occur in patients of any age. To prevent the possible drug interaction, nurses should confirm that the patient has not received an IV infusion either of ceftriaxone or of a solution containing calcium within the 48 hours directly preceding IV infusion of the other.