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ceftizoxime (Cefizox)
Tradename: Cefizox. 3rd generation cephalosporin.
Indications:
- treatment of bacterial infections due to susceptible organisms
- lower respiratory tract infections
- pneumonia
- skin or soft tissue infection
- osteomyelitis, infectious arthritis
- urogenital infections
- gonorrhea
- septicemia
- meningitis
- intra-abdominal infection
- proctitis
- empiric treatment of fever of unknown origin
Dosage:
1) 1-2 g IV every 8-12 hours
2) Children: 50 mg/kg/dose IV every 6-8 hours
Powder for injection: 1 & 2 g.
Dosage adjustment in renal failure:
creatinine clearance dosage
> 50-90 mL/min 1-2 g every 8-12 hours
10-50 mL/min* 1-2 g every 12-24 hours
< 10 mL/min# 1-2 g every 24 hours
* same dose for continuous arteriovenous hemofiltration
# 1 g IV after hemodialysis
Pharmacokinetics:
1) widely distributed into most body tissues
a) including gallbladder, liver, kidney, bone, sputum, bile, pleural fluid, synovial fluid,
b) good CSF penetration
c) crosses placenta
d) small amounts appear in breast milk
2) protein binding 30%
3) peak serum levels 30-60 minutes after IM injection
4) elimination 1/2life 1.6 hours, (15-35 hours ESRD)
5) excreted unchanged in the urine
6) moderately dialyzable
Antimicrobial activity:
Gram positive
- Streptococcus
- Streptococcus group A
- Streptococcus group B
- Streptococcus group C
- Streptococcus group G
- Streptococcus pneumonia (30% resistant)
- Streptococcus viridans, milleri
- Staphylococcus aureus (MRSA)
- Staphylococcus epidermidis (+/-)
Gram negative
- Neisseria gonorrhoeae
- Neisseria meningitidis
- Moraxella catarrhalis
- Haemophilus influenzae
- Escherichia coli
- Klebsiella species
- Enterobacter species
- Serratia species
- Salmonella species
- Shigella species
- Proteus mirabilis
- Proteus vulgaris
- Providencia species
- Morganella species
- Morganella morganii [6]
- Citrobacter species
- Aeromonas species
- Acinetobacter species
- Pseudomonas aeruginosa (+/-)
- Pseudomonas cepacia
- Yersinia enterocolitica
- Pasteurella multocida
- Haemophilus ducreyi
Anaerobes
- Actinomyces
- Bacteroides fragilis (+/-)
- Bacteroides melaninogenicus
- Clostridium species
- Peptostreptococcus species
Adverse effects:
1) not common (1-10%)
- rash, fever, pruritus, transient elevations of serum transaminases & alkaline phosphatase, eosinophilia, thrombocytosis, pain, burning at injection site
2) uncommon (< 1%)
- numbness, elevation of bilirubin, transient elevation of BUN & creatinine, anemia, leukopenia, neutropenia, thrombocytopenia, vaginitis
3) other
- hypersensitivity: rash, eosinophilia
- phlebitis
- 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 1.8 +/- 0.7 HOURS
protein-binding 28%
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