Ceftazidime; Indications, Dosage, Side Effects, Interactions

Ceftazidime; Indications, Dosage, Side Effects, Interactions

Ceftazidime is a beta-lactam, third-generation broad-spectrum semisynthetic,  bactericidal activity with antibacterial cephaloridine and used especially for Pseudomonas and other gram-negative infections in debilitated patients. Ceftazidime binds to and inactivates penicillin-binding proteins (PBP) located on the inner membrane of the bacterial cell wall. PBPs participate in the terminal stages of assembling the bacterial cell wall, and in reshaping the cell wall during cell division. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This results in the weakening of the bacterial cell wall and causes cell lysis. Compared to the second and first generation cephalosporins, ceftazidime is more active against gram-negative bacteria and less active against gram-positive bacteria. Ceftazidine also crosses the blood-brain barrier and reaches therapeutic concentrations in the central nervous system (CNS).

Mechanism of Action of Ceftazidime

The bactericidal activity of ceftazidime results from the inhibition of cell wall synthesis via affinity for penicillin-binding proteins (PBPs).Ceftazidime is a semisynthetic, broad-spectrum, beta-lactam antibiotic for parenteral administration. Ceftazidime is bactericidal in action exerting its effect by inhibition of enzymes responsible for cell-wall synthesis, primarily penicillin binding protein 3 (PBP3). A wide range of gram-negative organisms is susceptible to ceftazidime in vitro, including strains resistant to gentamicin and other aminoglycosides. In addition, ceftazidime has been shown to be active against gram-positive organisms. It is highly stable to most clinically important beta-lactamases, plasmid or chromosomal, which are produced by both gram-negative and gram-positive organisms and, consequently, is active against many strains resistant to ampicillin and other cephalosporins. Ceftazidime has activity against the gram-negative organisms Pseudomonas and Enterobacteriaceae. Its activity against Pseudomonas is a distinguishing feature of ceftazidime among the cephalosporins.

Indications of Ceftazidime

  • Bacterial infections
  • Bloodstream infections
  • Bone and joint infections
  • Central nervous system infections
  • Complicated urinary tract infections caused by susceptible Gram-negative microorganisms
  • Meningitis
  • Sepsis
  • Endocarditis
  • Endometritis
  • Febrile neutropenia
  • Intraabdominal infection
  • Melioidosis
  • Osteomyelitis
  • Otitis externa
  • Otitis media
  • Pelvic inflammatory disease
  • Peritonitis
  • Pneumonia
  • Pneumonia with cystic fibrosis
  • Pyelonephritis
  • Sinusitis
  • Skin or soft tissue infection
  • Cystitis
  • Urinary tract infection
  • Lower respiratory tract infection
  • Skin structures and soft tissue infections
  • Urinary tract infections
  • Ventilator-associated bacterial pneumonia caused by susceptible Gram-negative microorganisms
  • Hospital-acquired bacterial pneumonia caused by susceptible Gram-negative microorganisms
  • Susceptible intra-abdominal infection caused by the susceptible Gram-negative microorganism
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Contra-Indications of Ceftazidime

  • Liver problems
  • Interstitial nephritis
  • Subacute cutaneous lupus erythematosus
  • Systemic lupus erythematosus
  • Allergies cephalosporins & beta-lactams

Dosage of Ceftazidime

Strengths: 500 mg; 1 g; 2 g; 6 g; 1 g/50 mL; 2 g/50 mL;

Osteomyelitis

  • 2 g IV every 8 hours
  • Therapy should be continued for approximately 4 to 6 weeks, depending on the nature and severity of the infection.

Meningitis

  • 2 g IV every 8 hours for 14 days, depending on the nature and severity of the infection

Sepsis

  • 2 g IV every 8 hours for 14 days, depending on the nature and severity of the infection

Endocarditis

  • 2 g IV every 8 hours
  • Treatment may be required for 6 weeks or more, depending on the nature and severity of the infection.

Joint Infection

  • 2 g IV every 8 hours
  • Therapy should be continued for approximately 3 to 4 weeks, depending on the nature and severity of the infection.
  • Longer therapy, 6 weeks or more, may be required for prosthetic joint infections.

Intra abdominal Infection

  • 2 g IV every 8 hours for 7 to 14 days, depending on the nature and severity of the infection

 

Otitis Media

  • Otitis media in hospitalized intubated patients: 2 g IV every 8 hours

Pelvic Inflammatory Disease

  • 2 g IV or IM every 8 hours
  • Therapy should be continued for at least 48 hours after clinical improvement is demonstrated.
  • Oral therapy should then be continued to complete a 14-day course of treatment.

Peritonitis

  • 1 to 2 g IV every 8 hours for 10 to 14 days, depending on the nature and severity of the infection
  • Peritoneal dialysis patients (ceftazidime sodium):
  • Intermittent: 1 g/2 L dialysate intraperitoneally once daily
  • Continuous: 1 g /2 L dialysate intraperitoneally, followed by 250 to 500 mg/2 L dialysate

Pneumonia

  • 1 to 2 g IV or IM every 8 hours
  • Therapy should be continued for 7 to 21 days, depending on the nature and severity of the infection.

Pneumonia with Cystic Fibrosis

  • Lung infections caused by Pseudomonas: 30 to 50 mg/kg IV every 8 hours to a maximum of 6 g/day, in patients with normal renal function

Sinusitis

  • Sinusitis in intubated patients: 2 g IV every 8 hours for 10 to 14 days, depending on the nature and severity of the infection

Skin or Soft Tissue Infection

  • 1 to 2 g IV or IM every 8 hours
  • Therapy should be continued for approximately 7 to 10 days, or for 3 days after the acute inflammation disappears, depending on the nature and severity of the infection.
  • For more severe infections, such as diabetic soft tissue infections, 14 to 21 days of therapy may be required.
  • Vibrio vulnificus: 1 to 2 g IV every 8 hours plus doxycycline 100 mg IV or orally every 12 hours or ciprofloxacin 400 mg IV every 12 hours.
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Urinary Tract Infection

  • Uncomplicated: 250 mg IV or IM every 12 hours for approximately 3 to 7 days, depending on the nature and severity of the infection
  • Complicated: 500 mg IV or IM every 8 to 12 hours for 2 to 3 weeks, depending on the nature and severity of the infection
  • Parenteral therapy is generally not indicated for uncomplicated infections.

Pediatric Bacteremia

  • 0 to 4 weeks, birthweight 1199 g or less: 30 to 50 mg/kg IV every 12 hours
  • 0 to 7 days, birthweight 1200 to 2000 g: 30 to 50 mg/kg IV every 12 hours
  • 0 to 7 days, birthweight 2001 g or more: 30 to 50 mg/kg IV every 8 to 12 hours
  • 7 days to 4 weeks, birthweight 1200 g or more: 30 to 50 mg/kg IV every 8 to 12 hours
  • 1 month to 12 years: 30 to 50 mg/kg IV every 8 hours; maximum dose is 6 g/day13 years or older

Side Effects

The most common

More common

Rare

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Drug Interactions

Ceftazidime may interact with the following drugs, supplements, & may change the efficacy of drugs

Pregnancy Catagory

FDA Pregnancy Category  B

Pregnancy

It is not known if ceftazidime is safe for use by pregnant women. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Lactation

This medication may passes into breast milk. If you are a breast-feeding mother and are taking ceftazidime it may affect your baby. Talk to your doctor about whether you should continue breast-feeding. It is not known if ceftazidime is safe for children under 6 months of age.

References

  1. https://pubchem.ncbi.nlm.nih.gov

Ceftazidime

 

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