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

Pregnancy category: B Lactation: Drug excreted in breast milk; use with caution

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.