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Third Generation Anti-Pseudomonal Cephalosporins

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Third Generation Anti-Pseudomonal Cephalosporins, Ceftazidime, Fortaz, Ceftazidime-Avibactam, Zavicefta

  • See Also
  1. Third Generation Broad-Spectrum Cephalosporins
  2. Cephalosporin
  • Indications
  • Conditions
  1. Gram-Negative, Multi-drug resistant intraabdominal Infections and Urinary Tract Infections
  • Pharmacokinetics
  1. Half-Life Ceftazidime: 2.7 (similar for Avibactam)
  2. Ceftazidime is excreted in urine (80-90% unchanged)
  3. Adjust dose in Renal Failure
  1. Pseudomonas aeruginosa (Main indication)
  2. EKP Gram Negative Bacteria
  3. ESP Gram Negative Bacteria
  4. Gram Positive Cocci poorly covered
  5. No Gram Negative Coccobacilli coverage
  • Preparations
  1. Ceftazidime (Fortaz)
    1. Adult: 1-2 grams IM or IV every 8 to 12 hours
    2. Child: 30-50 mg/kg IV every 8 hours
  2. Ceftazidime-Avibactam (Zavicefta)
    1. Addition of Beta-Lactamase inhibitor (Avibactam) circumvents Beta-Lactamase resistance
    2. Ceftazidime-Avibactam (2g-0.5g) 62.5 g IV every 8 hours for 7-14 days
    3. Combined with Metronidazole for intraabdominal infections
  • Precautions
  1. Avoid Avibactam in pregnancy (adverse effects in pregnancy)
  • Disadvantages
  1. Most expensive
  2. Limited spectrum
  • Adverse Effects
  1. Gastrointestinal (Nausea, Vomiting, Diarrhea, Constipation)
  2. Dizziness
  3. Anxiousness
  4. Abdominal Pain
  5. Paresthesias
  • References
  1. Morrison and LoVecchio (2021) Crit Dec Emerg Med 35(1): 28