Ceftazidime information from DrugsUpdate
P - Caution when used during pregnancy
L - Caution when used during lactation
LI - Lab*
Ceftazidime is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria. Unlike most third-generation agents, it is active against Pseudomonas aeruginosa, however it has weaker activity against Gram-positive microorganisms and is not used for such infections. Ceftazidime pentahydrate is marketed under various trade names including Cefzim (Pharco B International), Fortum (GSK), and Fortaz. It is also sometimes referred to as the "Tasmanian Devil," due to its fairly powerful anti-pseudomonal activity.
Pharmacodynamics
Pharmacokinetics
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.
Absorption: Peak plasma concentrations after 1 hr (IM), 5 min (IV bolus).
Distribution: Widely distributed in body tissues and fluids; CSF (therapeutic concentrations when meninges are inflamed). Crosses the placenta and enters breast milk. Protein-binding: 10%
Excretion: Mainly by the kidneys via the urine by glomerular filtration (80-90% as unchanged drug within 24 hr); passively excreted in bile but only a small proportion is eliminated. Clearance enhanced in cystic fibrosis; 2 hr (elimination half-life), prolonged in neonates and renal impairment.
Ceftazidime Indications / Ceftazidime Uses
Information Not Available
Ceftazidime Adverse Reactions / Ceftazidime Side Effects
Hypersensitivity, dizziness, diarrhoea, nausea, vomiting, renal impairment, rash, erythema multiforme, thrombocytopaenia, superinfection, phloebitis and thrombophloebitis at the site of injection.
Potentially Fatal: Anaphylactic reactions, nephrotoxicity, pseudomembranous colitis.
Precautions
Monitor
Response to therapy
Monitor patient's response to therapy. Notify health care provider if infection does not appear to improve or worsens.
Special Precautions
History of penicillin allergy; severe renal impairment; pregnancy, lactation
Other Drug Interactions
Probenecid may decrease ceftazidime elimination time.
Potentially Fatal: Furosemide and aminoglycosides may increase nephrotoxicity.
Other Interactions
Information Not Available
Dosage
Parenteral
Pseudomonal lung infections in cystic fibrosis
Adult: 90-150 mg/kg/day in 3 divided doses via IM or IV inj or IV infusion, up to 9 g/day. Doses >1 g should be given via IV route.
Max Dosage: 9 g daily. Doses >1 g should be administered IV.
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.
Parenteral
Prophylaxis of surgical infection in patients undergoing prostate surgery
Adult: 1 g at induction of anesth repeated if necessary upon removal of catheter.
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.
Parenteral
Biliary tract infections
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
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.
Parenteral
Bone and joint infections
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
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.
Parenteral
Infections in immunocompromised patients
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
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.
Parenteral
Meningitis
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
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.
Parenteral
Peritonitis
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
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.
Parenteral
Pneumonia
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
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.
Parenteral
Skin infection
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
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.
Parenteral
Melioidosis
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
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.
Parenteral
Upper resp tract infections
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
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.
Parenteral
Endophthalmitis
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
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.
Parenteral
Urinary tract infections
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
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.
Food(before/after)
Information Not Available
List of Contraindications
Ceftazidime and Pregnancy
Caution when used during pregnancy.
Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).
Ceftazidime and Lactation
Caution when used during lactation
Ceftazidime and Children
Information Not Available
Ceftazidime and Geriatic
Information Not Available
Ceftazidime and Other Contraindications
Hypersensitivity to cephalosporins
Storage
Parenteral: Store at 15-30°C
Lab interference
Parenteral: Store at 15-30°C
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