II. Indications
- See Third Generation Anti-Pseudomonal Cephalosporin
- Conditions
- Gram-Negative, Multi-drug resistant intraabdominal Infections and Urinary Tract Infections
- No anaerobic coverage (add Metronidazole for abdominal infections)
- Pseudomonas infections
- Pseudomonas Osteochondritis
- Cystic Fibrosis lung infection
- Gram-Negative, Multi-drug resistant intraabdominal Infections and Urinary Tract Infections
- Ceftazidime Bacterial Coverage
- Pseudomonas aeruginosa (Main indication)
- EKP Gram Negative Bacteria (Escherichia coli, Klebsiella, Proteus)
- ESP Gram Negative Bacteria (Enterobacter, Serratia, Providencia)
- Also covers Citrobacter species
- Gram Positive Cocci poorly covered
- No Gram Negative Coccobacilli coverage
III. Pharmacokinetics
- Half-Life Ceftazidime: 2.7 hours (similar for Avibactam)
- Ceftazidime is excreted in urine (80-90% unchanged, avibactam is 100% unchanged on excretion)
- Adjust dose in Renal Failure
IV. Dosing: Adult (and age >12 years)
-
Urinary Tract Infections
- Give 0.25 to 0.5 g IM or IV every 8 to 12 hours
- Mild to Moderate Infections (Skin Infections)
- Give 0.5 to 1 g IM or IV every 8 hours
- Severe Infections (Sepsis, intra-abdominal infection, bone and joint infection, Neutropenic Fever)
- Give 2 g IV every 8 hours
-
Pseudomonas lung infection in Cystic Fibrosis
- Give 30 to 50 mg/kg IV every 8 hours (max 6 g/day)
-
Renal Dosing
- eGFR 31 to 50 ml/min
- Give 1 g IV every 12 hours
- eGFR 16 to 30 ml/min
- Give 1 g IV every 24 hours
- eGFR 6 to 15 ml/min
- Load 1 g IV, then give 500 mg every 24 hours
- eGFR <5 ml/min
- Load 1 g IV, then give 500 mg every 48 hours
-
Hemodialysis
- Load 1 g IV, then give 1 g IV after each Hemodialysis session
- eGFR 31 to 50 ml/min
V. Dosing: Child (age <12 years)
- Give 35 to 50 mg/kg IV every 8 hours (every 12 hours in age <1 week)
- Use 50 mg/kg in Meningitis
- Maximum: 6 g/day
VI. Safety
- Pregnancy Category B
- Consider safe in Lactation
- Ceftazidime is excreted in Breast Milk
VII. Efficacy
- Limited spectrum (focused Gram NegativeBacillus and Pseudomonas coverage)
VIII. Adverse Effects
- Gastrointestinal (Nausea, Vomiting, Diarrhea, Constipation)
- Dizziness
- Anxiousness
- Abdominal Pain
- Paresthesias
- CNS toxicity
- Associated with high drug levels in renal dysfunction
IX. Resources
X. References
- Morrison and LoVecchio (2021) Crit Dec Emerg Med 35(1): 28
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Definition (NCI) | A beta-lactam, third-generation cephalosporin antibiotic with bactericidal activity. Ceftazidime binds to and inactivates penicillin-binding proteins (PBP) located on the inner membrane of the bacterial cell wall. PBPs participate in the terminal stages of assembling the bacterial cell wall, and in reshaping the cell wall during cell division. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This results in the weakening of the bacterial cell wall and causes cell lysis. Compared to the second and first generation cephalosporins, ceftazidime is more active against gram-negative bacteria and less active against gram-positive bacteria. Ceftazidine also crosses the blood-brain barrier and reaches therapeutic concentrations in the central nervous system (CNS). |
Definition (MSH) | Semisynthetic, broad-spectrum antibacterial derived from CEPHALORIDINE and used especially for Pseudomonas and other gram-negative infections in debilitated patients. |
Concepts | Antibiotic (T195) , Organic Chemical (T109) |
MSH | D002442 |
SnomedCT | 323836005, 36893000, 387200005 |
LNC | LP15242-8, MTHU003920 |
English | Ceftazidime, Pyridinium, 1-((7-(((2-amino-4-thiazolyl)((1-carboxy-1-methylethoxy)imino)acetyl)amino)-2-carboxy-8-oxo-5-thia-1-azabicyclo(4.2.0)oct-2-en-3-yl)methyl)-, inner salt, pentahydrate, (6R-(6alpha,7beta(Z)))-, ceftazidime, ceftazidime (medication), CEFTAZIDIME, Ceftazidime [Chemical/Ingredient], cefTAZidime, CefTAZidime, Pyridinium, 1-((7-(((2-amino-4-thiazolyl)((1-carboxy-1-methylethoxy)imino)acetyl)amino)-2-carboxy-8-oxo-5-thia-1-azabicyclo(4.2.0)oct-2-en-3-yl)methyl)-, Hydroxide, Inner Salt, Pentahydrate, (6R-(6alpha,7beta(Z)))-, Ceftazidime (product), Ceftazidime (substance) |
Swedish | Ceftazidim |
Czech | ceftazidim |
Finnish | Keftasidiimi |
Russian | TSEFTAZIDIM, ЦЕФТАЗИДИМ |
Japanese | セフタジジム |
Croatian | CEFTAZIDIM |
Polish | Ceftazydym |
Spanish | ceftazidima (producto), ceftazidima (sustancia), ceftazidima, Ceftazidima |
French | Ceftazidime |
German | Ceftazidim |
Italian | Ceftazidima |
Portuguese | Ceftazidima |
Ontology: Fortaz (C0700859)
Concepts | Antibiotic (T195) , Organic Chemical (T109) |
MSH | D002442 |
English | Fortaz ADD-Vantage, fortaz, Fortaz |