Ceftazidime

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General

  • Type: Third generation cephalosporin
  • Dosage Forms: injectable solution, powder for injection
  • Dosage Strengths: injectable solution: 20mg/mL, 40mg/mL; powder for injection: 500mg, 1g, 2g, 6g
  • Routes of Administration: IV, IM
  • Common Trade Names: Fortaz, Tazicef, Tazidime

Adult Dosing

Infections, Bacterial

  • 1 g IV/IM q8-12h
    • Max: 6 g/day

Pneumonia, Hospital-acquired or ventilator-associated

  • 2 g IV q8h x7 days

Pediatric Dosing

Infections, Bacterial

  • Neonates 0-7 days old
    • 100 mg/kg/day IM/IV divided q12h
  • Neonates >7 days old, <1200g
    • 100mg/kg/day IM/IV divided q12h
  • Neonates >7 days old, >1200g
    • 150mg/kg/day IM/IV divided q8h
  • 1mo - 12yo
    • 90-150 mg/kg/day IM/IV divided q8h
      • Max: 6 g/day
      • Reserve high dose for immunocompromised, cystic fibrosis, or meningitis

Special Populations

  • Pregnancy: C; May use during pregnancy
  • Lactation: No known risk
  • Renal Dosing
    • Adult
      • CrCl 31-50: Give q12h
      • CrCl 16-30: Give q24h
      • CrCl 6-15: 1 g x1, then 500mg q24h
      • CrCl <5: 1 g x1, then 500mg q48h
      • HD: 1 g x1, then give 1 g after dialysis, no supplement
      • PD: 1 g x1, then 500mg q24h, no supplement
    • Pediatric
      • CrCl 30-50: Give q12h
      • CrCl 10-29: Give q24h
      • CrCl <10: Give q48h
      • HD/PD: No supplement
  • Hepatic Dosing
    • Adult: No adjustment
    • Pediatric: No adjustment

Contraindications

  • Allergy to class/drug
  • Caution:
    • Hypersensitivity to [penicillin]
    • Renal impairment
    • Concurrent nephrotoxic agent
    • Seizure disorder
    • Recent abx-associated colitis

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 1.9h
  • Metabolism: Minimal
  • Excretion: Urine primarily
  • Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep I
Strep. anginosus gp X1
Enterococcus faecalis R
Enterococcus faecium X1
MSSA I
MRSA R
CA-MRSA R
Staph. Epidermidis I
C. jeikeium R
L. monocytogenes R
Gram Negatives N. gonorrhoeae I
N. meningitidis I
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg S
Enterobacter sp, AmpC pos R
Serratia sp S
Serratia marcescens X1
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. S
Citrobacter freundii R
Citrobacter diversus S
Citrobacter sp. S
Aeromonas sp S
Acinetobacter sp. I
Pseudomonas aeruginosa S
Burkholderia cepacia S
Stenotrophomonas maltophilia I
Yersinia enterocolitica I
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida X1
Haemophilus ducreyi S
Vibrio vulnificus X1
Misc Chlamydophila sp X1
Mycoplasm pneumoniae X1
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces X1
Bacteroides fragilis R
Prevotella melaninogenica S
Clostridium difficile X1
Clostridium (not difficile) S
Fusobacterium necrophorum X1
Peptostreptococcus sp. S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. Sanford Guide to Antimicrobial Therapy 2014