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ceftazidime (Fortaz, Tazidime, Tazicef)
Tradenames: Fortaz, Tazidime, Tazicef. 3rd generation cephalosporin.
Indications:
- treatment of bacterial infections due to susceptible organisms
- treatment of Pseudomonas aeruginosa infection
- meliodosis [6]
- bacterial meningitis
- lower respiratory tract infection
- pneumonia
- ventilator-associated pneumonia
- intra-abdominal infections
- bacterial peritonitis
- urogenital infections
- pelvic inflammatory disease
- endometritis
- cervicitis
- infections in patients with cystic fibrosis
- skin or soft tissue infections
- diabetic foot infection
- ecthyma gangrenosum
- infectious arthritis, osteomyelitis
- empiric therapy of a febrile neutropenia
- empiric therapy of fever of unknown origin
- empiric treatment of neonatal infection [6]
Dosage:
1) 1-2 g IV every 8-12 hours
2) infants & children: 30-50 mg/kg every 8 hours (every 12 hours if < 7 days)
3) maximum: 6 g/day
Dosage adjustment in renal failure:
creatinine clearance dosage
31-50 mL/min every 12 hours
16-30 mL/min every 24 hours
< 15 mL/min every 24-48 hours
1 g IV after hemodialysis
Pharmacokinetics:
1) complete absorption after IV or IM administration
2) widely distributed to body tissues
a) including bone, bile, skin, endometrium, heart, pleural fluid, lymphatics
b) CSF penetration increased with inflamed meninges
c) crosses placenta
d) appears in breast milk
3) protein binding 5-24%
4) time to peak serum levels after IM administration: 60 min
5) elimination 1/2 life 1-2 hours, (13-25 hours ESRD)
6) 80-90% eliminated unchanged in the urine
7) elimination by hemodialysis: 50-100%
Antimicrobial activity:
Gram positive
- Streptococcus
- Streptococcus group A
- Streptococcus group B
- Streptococcus group C
- Streptococcus group G
- Streptococcus pneumonia
- Streptococcus viridans, milleri
- Staphylococcus aureus (MRSA)
- Staphylococcus epidermidis (+/-)
Gram negative
- Pseudomonas aeruginosa
- Pseudomonas cepacia
- Neisseria gonorrhoeae
- Neisseria meningitidis
- Moraxella catarrhalis
- Haemophilus influenzae
- Haemophilus ducreyi
- Escherichia coli
- Klebsiella species
- Enterobacter species
- Serratia species
- Salmonella species
- Shigella species
- Proteus mirabilis
- Proteus vulgaris
- Providencia species
- Morganella species
- Citrobacter species
- Citrobacter diversus
- Aeromonas species
- Acinetobacter species
- Xanthomonas maltophilia (+/-)
- Yersinia enterocolitica
- Yersinia pseudotuberculosis [6]
Anaerobes
- Bacteroides melaninogenicus (+/-)
- Clostridium species
- Peptostreptococcus species
Adverse effects:
1) not common (1-10%)
- diarrhea, pain at site of injection
2) uncommon (< 1%)
- fever, headache, dizziness, paresthesia, rash, angioedema, nausea/vomiting, pseudomembranous colitis, eosinophilia, thrombocytosis, transient leukopenia, hemolytic anemia, transient elevation in serum transaminases, BUN & creatinine, phlebitis, candidiasis
3) other
- dose-related neurotoxicity (in elderly)
- bleeding secondary to coagulopathy (in elderly)
- Coomb's test may be positive
Laboratory:
1) specimen:
a) serum
b) keep specimen on ice-water
c) centrifuge at 4 degrees C
d) remove cells as soon as possible
e) freeze at -70 degrees C until assayed
2) methods: HPLC, MB
Interactions
drug interactions
drug adverse effects of cephalosporins
General
cephalosporin, 3rd generation
Properties
MISC-INFO: elimination route KIDNEY
1/2life 1.6 HOURS
protein-binding 17%
elimination by hemodialysis +
peritoneal dialysis +
pregnancy-category B
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Harrison's Principles of Internal Medicine, 13th ed.
Companion Handbook. Isselbacher et al (eds),
McGraw-Hill Inc. NY, 1995, pg 162
- Sanford Guide to antimicrobial therapy 1997
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed.,
W.B. Saunders, 1995
- Deprecated Reference
- Department of Veterans Affairs, VA National Formulary
Component-of
avibactam/ceftazidime (Avycaz)
ceftazidime-avibactam