Ceftazidime

Indications

Ceftazidime is used for: Pneumonia, Cystic fibrosis, Bacterial septicemia, Meningitis, Peritonitis, Skin and Skin-Structure Infections, Endometritis, Pelvic cellulitis, Respiratory tract infections, Urinary tract infections, Febrile neutropenia, Melioidosis, Bone and Joint Infections,G ynecologic Infections, Biliary tract infections, Endophthalmitis

Adult Dose

Bone & Joint Infections 2 g IV q12hr Gynecologic & Intra-abdominal Infections, Meningitis, Complicated Pneumonia, Life-Threatening Infections 2 g IV q8hr Pulmonary Infections Infections caused by Pseudomonas spp in patients with cystic fibrosis who have healthy renal function 30-50 mg/kg IV q8hr; not to exceed 6 g/day Uncomplicated Pneumonia 0.5-1 g IV q8hr Mild Skin/Skin Structure Infections 0.5-1 g IV or IM q8hr Urinary Tract Infections Complicated: 500 mg IV or IM q8-12hr Uncomplicated: 250 mg IV or IM q12hr Elderly: >80 yr Max: 3 g daily.

Child Dose

Child: IV, IM 90–150 mg/kg/day q8h IV 200–300 mg/kg/day for serious Pseudomonas infection (max 8–12 g/day) q8h

Renal Dose

Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period. CrCl (ml/min) 31-50 1 g every 12 hr. 16-30 1 g every 24 hr. 6-15 500 mg every 24 hr. <5 500 mg every 48 hr.

Administration

IV/IM Administration IV Direct injection: Inject over 3-5 minutes directly into vein or through tubing of running compatible infusion solution Infusion: Infuse intermittently over 15-30 minutes IM Inject deeply

Contra Indications

Hypersensitivity to cephalosporins.

Precautions

History of penicillin allergy; severe renal impairment; pregnancy, lactation. Lactation: Drug excreted in breast milk; use with caution

Pregnancy-Lactation

Interactions

May increase nephrotoxicity of aminoglycosides. May diminish therapeutic effect of BCG, typhoid vaccine, Na picosulfate. May increase anticoagulant effect of vit K antagonists (e.g. warfarin). May increase serum level w/ probenecid.

Adverse Effects

Side effects of Ceftazidime : 1-10% Transient increases in transaminases (3-9%),Eosinophilia (<7%),Diarrhea (<2%),Immune hypersensitivity reaction (2%),Phlebitis (<2%),Rash (maculopapular or erythematous) (2%),Thrombocytosis (2%),Injection site pain (1%) <1% Abdominal pain,Agranulocytosis,Angioedema,Asterixis,Coma,Dizziness,Encephalopathy,Fever,Hallucinations,Increased serum concentrations of bilirubin,Leukopenia,Lymphocytosis,Metallic taste,Myoclonia,Nausea or vomiting,Neuromuscular excitability,Neutropenia,Paresthesia,Photosensitivity,Pruritus,Seizures,Thrombocytopenia,Transient increases in blood urea nitrogen (BUN) or serum creatinine,Urticaria Potentially Fatal: Anaphylactic reactions, nephrotoxicity, pseudomembranous colitis.

Mechanism of Action

Ceftazidime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.