Pharm

Ceftazidime

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Ceftazidime, Fortaz, Tazicef

  • See Also
  1. Third Generation Anti-Pseudomonal Cephalosporin
  2. Ceftazidime-Avibactam
  3. Cephalosporin
  • Indications
  1. See Third Generation Anti-Pseudomonal Cephalosporin
  2. Conditions
    1. Gram-Negative, Multi-drug resistant intraabdominal Infections and Urinary Tract Infections
      1. No anaerobic coverage (add Metronidazole for abdominal infections)
    2. Pseudomonas infections
      1. Pseudomonas Osteochondritis
      2. Cystic Fibrosis lung infection
  3. Ceftazidime Bacterial Coverage
    1. Pseudomonas aeruginosa (Main indication)
    2. EKP Gram Negative Bacteria (Escherichia coli, Klebsiella, Proteus)
    3. ESP Gram Negative Bacteria (Enterobacter, Serratia, Providencia)
    4. Also covers Citrobacter species
    5. Gram Positive Cocci poorly covered
    6. No Gram Negative Coccobacilli coverage
  • Pharmacokinetics
  1. Half-Life Ceftazidime: 2.7 hours (similar for Avibactam)
  2. Ceftazidime is excreted in urine (80-90% unchanged, avibactam is 100% unchanged on excretion)
  3. Adjust dose in Renal Failure
  • Dosing
  • Adult (and age >12 years)
  1. Urinary Tract Infections
    1. Give 0.25 to 0.5 g IM or IV every 8 to 12 hours
  2. Mild to Moderate Infections (Skin Infections)
    1. Give 0.5 to 1 g IM or IV every 8 hours
  3. Severe Infections (Sepsis, intra-abdominal infection, bone and joint infection, Neutropenic Fever)
    1. Give 2 g IV every 8 hours
  4. Pseudomonas lung infection in Cystic Fibrosis
    1. Give 30 to 50 mg/kg IV every 8 hours (max 6 g/day)
  5. Renal Dosing
    1. eGFR 31 to 50 ml/min
      1. Give 1 g IV every 12 hours
    2. eGFR 16 to 30 ml/min
      1. Give 1 g IV every 24 hours
    3. eGFR 6 to 15 ml/min
      1. Load 1 g IV, then give 500 mg every 24 hours
    4. eGFR <5 ml/min
      1. Load 1 g IV, then give 500 mg every 48 hours
    5. Hemodialysis
      1. Load 1 g IV, then give 1 g IV after each Hemodialysis session
  • Dosing
  • Child (age <12 years)
  1. Give 35 to 50 mg/kg IV every 8 hours (every 12 hours in age <1 week)
  2. Use 50 mg/kg in Meningitis
  3. Maximum: 6 g/day
  • Safety
  1. Pregnancy Category B
  2. Consider safe in Lactation
    1. Ceftazidime is excreted in Breast Milk
  • Efficacy
  1. Limited spectrum (focused Gram Negative bacillus and Pseudomonas coverage)
  • Adverse Effects
  1. Gastrointestinal (Nausea, Vomiting, Diarrhea, Constipation)
  2. Dizziness
  3. Anxiousness
  4. Abdominal Pain
  5. Paresthesias
  6. CNS toxicity
    1. Associated with high drug levels in renal dysfunction
  • Resources
  1. Ceftazidime (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=22d6534c-4488-48a1-8d78-e2fb908259de
  • References
  1. Morrison and LoVecchio (2021) Crit Dec Emerg Med 35(1): 28