Ceftazidime

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 PositiveStrep. Group A, B, C, GS
Strep. PneumoniaeS
Viridans strepI
Strep. anginosus gpX1
Enterococcus faecalisR
Enterococcus faeciumX1
MSSAI
MRSAR
CA-MRSAR
Staph. EpidermidisI
C. jeikeiumR
L. monocytogenesR
Gram NegativesN. gonorrhoeaeI
N. meningitidisI
Moraxella catarrhalisS
H. influenzaeS
E. coliS
Klebsiella spS
E. coli/Klebsiella ESBL+R
E coli/Klebsiella KPC+R
Enterobacter sp, AmpC negS
Enterobacter sp, AmpC posR
Serratia spS
Serratia marcescensX1
Salmonella spS
Shigella spS
Proteus mirabilisS
Proteus vulgarisS
Providencia sp.S
Morganella sp.S
Citrobacter freundiiR
Citrobacter diversusS
Citrobacter sp.S
Aeromonas spS
Acinetobacter sp.I
Pseudomonas aeruginosaS
Burkholderia cepaciaS
Stenotrophomonas maltophiliaI
Yersinia enterocoliticaI
Francisella tularensisX1
Brucella sp.X1
Legionella sp.R
Pasteurella multocidaX1
Haemophilus ducreyiS
Vibrio vulnificusX1
MiscChlamydophila spX1
Mycoplasm pneumoniaeX1
Rickettsia spX1
Mycobacterium aviumX1
AnaerobesActinomycesX1
Bacteroides fragilisR
Prevotella melaninogenicaS
Clostridium difficileX1
Clostridium (not difficile)S
Fusobacterium necrophorumX1
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
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