ceftazidime (Fortaz, Tazidime, Tazicef)
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Introduction
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
- intra-abdominal infections
- urogenital infections
- infections in patients with cystic fibrosis
- skin or soft tissue infections
- infectious arthritis, osteomyelitis
- empiric therapy of a febrile neutropenia
- empiric therapy of fever of unknown origin
- empiric treatment of neonatal infection[6]
Dosage
- 1-2 g IV every 8-12 hours
- infants & children: 30-50 mg/kg every 8 hours (every 12 hours if < 7 days)
- maximum: 6 g/day
Dosage adjustment in renal failure
Table
| 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
- complete absorption after IV or IM administration
- widely distributed to body tissues
- including bone, bile, skin, endometrium, heart, pleural fluid, lymphatics
- CSF penetration increased with inflamed meninges
- crosses placenta
- appears in breast milk
- protein binding 5-24%
- time to peak serum levels after IM administration: 60 min
- elimination 1/2 life 1-2 hours, (13-25 hours ESRD)
- 80-90% eliminated unchanged in the urine
- elimination by hemodialysis: 50-100%
elimination via kidney
1/2life = 1.6 hours
protein binding = 17 %
elimination by hemodialysis = +
elimination by peritoneal dialysis = +
Antimicrobial activity
- 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
- Aeromonas species
- Acinetobacter species
- Xanthomonas maltophilia (+/-)
- Yersinia enterocolitica
- Yersinia pseudotuberculosis[6]
Adverse effects
- not common (1-10%)
- diarrhea, pain at site of injection
- 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
- other
- dose-related neurotoxicity (in elderly)
- bleeding secondary to coagulopathy (in elderly)
- Coomb's test may be positive
Laboratory
- specimen:
- serum
- keep specimen on ice-water
- centrifuge at 4 degrees C
- remove cells as soon as possible
- freeze at -70 degrees C until assayed
- methods: HPLC, MB
More general terms
Component of
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
- ↑ 6.0 6.1 6.2 6.3 Deprecated Reference
- ↑ Department of Veterans Affairs, VA National Formulary