Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 20mg/mL
- 40mg/mL
powder for injection
- 500mg
- 1g
- 2g
- 6g
Bone & Joint Infections
2 g IV q12hr
Gynecologic & Intra-abdominal Infections
2 g IV q8hr for 4-7 days
Pulmonary Infections
Infections caused by Pseudomonas spp in patients with cystic fibrosis who have healthy renal function
30-50 mg/kg IV q8hr; not to exceed 6 g/day
Meningitis
2 g IV q8hr
Pneumonia
Uncomplicated: 0.5-1 g IV q8hr
Complicated: 2 g IV q8hr
Mild Skin/Skin Structure Infections
0.5-1 g IV or IM q8hr
Urinary Tract Infections
Complicated: 500 mg IV or IM q8-12hr
Uncomplicated: 250 mg IV or IM q12hr
Life-Threatening Infections
Especially in immunocompromised patients
2 g IV q8hr
Dosing Modifications
Renal impairment
- Modifications based on 1-g dose
- CrCl 31-50 mL/min: 1 g q12hr
- CrCl 16-30 mL/min: 1 g q24hr
- CrCl 6-15 mL/min: 500 mg q24hr
- CrCl <5 mL/min: 500 mg q48hr
Dosing Considerations
Susceptible organisms
- Citrobacter spp, Clostridium spp, Enterobacter spp, Escherichia coli, Haemophilus influenzae, Klebsiella spp, Moraxella catarrhalis, Neisseria meningitidis, Proteus mirabilis, Pseudomonas spp, Serratia spp, Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes
Dosage Forms & Strengths
injectable solution
- 20mg/mL
- 40mg/mL
powder for injection
- 500mg
- 1g
- 2g
- 6g
Infections Caused by Susceptible Organisms
<1 month: Safety and efficacy not established
1 month-12 years: 30-50 mg/kg IV q8hr; not to exceed 6 g/day (higher end of dosing range reserved for patietns with immunocompromise, meningitis, or cystic fibrosis)
>12 years: 1-2 g IV q8hr
Dosing Considerations
Use sodium carbonate preparation
Usual dosing range for neonates (per manufacturer)
Usual dosing range for neonates (per American Academy of Pediatrics)
- 7-28 days: 50 mg/kg IV q8hr
- <7 days, <2 kg: 50 mg/kg IV q12hr
- <7 days, >2 kg: 50 mg/kg IV q8-12hr
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (3)
- BCG vaccine live
ceftazidime decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
- cholera vaccine
ceftazidime, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.
- typhoid vaccine live
ceftazidime decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
Monitor Closely (10)
- bazedoxifene/conjugated estrogens
ceftazidime will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- dienogest/estradiol valerate
ceftazidime will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. An alternate or additional form of birth control may be advisable during concomitant use.
- estradiol
ceftazidime will decrease the level or effect of estradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- estropipate
ceftazidime will decrease the level or effect of estropipate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- ethinylestradiol
ceftazidime will decrease the level or effect of ethinylestradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- levonorgestrel oral/ethinylestradiol/ferrous bisglycinate
ceftazidime will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.
- probenecid
probenecid will increase the level or effect of ceftazidime by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- sodium picosulfate/magnesium oxide/anhydrous citric acid
ceftazidime decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.
- voclosporin
voclosporin, ceftazidime. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- warfarin
ceftazidime increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.
Minor (12)
- acyclovir
ceftazidime will increase the level or effect of acyclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- aminohippurate sodium
ceftazidime will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- aspirin
ceftazidime will increase the level or effect of aspirin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- aspirin rectal
ceftazidime will increase the level or effect of aspirin rectal by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- aspirin/citric acid/sodium bicarbonate
ceftazidime will increase the level or effect of aspirin/citric acid/sodium bicarbonate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chloramphenicol
chloramphenicol decreases effects of ceftazidime by pharmacodynamic antagonism. Minor/Significance Unknown.
- choline magnesium trisalicylate
ceftazidime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- furosemide
ceftazidime increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.
- rose hips
rose hips will increase the level or effect of ceftazidime by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- salicylates (non-asa)
ceftazidime will increase the level or effect of salicylates (non-asa) by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- sulfasalazine
ceftazidime will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- willow bark
ceftazidime will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Adverse Effects
1-10%
Transient increases in transaminases (3-9%)
Eosinophilia (<7%)
Diarrhea (<2%)
Immune hypersensitivity reaction (2%)
Phlebitis (<2%)
Rash (maculopapular or erythematous) (2%)
Thrombocytosis (2%)
Injection site pain (1%)
<1%
Abdominal pain
Agranulocytosis
Angioedema
Asterixis
Coma
Dizziness
Encephalopathy
Fever
Hallucinations
Increased serum concentrations of bilirubin
Leukopenia
Lymphocytosis
Metallic taste
Myoclonia
Nausea or vomiting
Neuromuscular excitability
Neutropenia
Paresthesia
Photosensitivity
Pruritus
Seizures
Thrombocytopenia
Transient increases in blood urea nitrogen (BUN) or serum creatinine
Urticaria
Warnings
Contraindications
Documented hypersensitivity to drug or excipients, or to cephalosporin class of antibacterial drugs, penicillins or other beta-lactam antibacterial drugs
Cautions
High and prolonged serum ceftazidime concentrations can occur from usual dosages in patients with transient or persistent reduction of urinary output because of renal insufficiency; elevated levels of the drug in these patients can lead to, seizures, nonconvulsive status epilepticus (NCSE), encephalopathy, coma, asterixis, neuromuscular excitability, and myoclonus reported in patients treated with ceftazidime; adjust dosing based on creatinine clearance in patients with renal impairment
Elevated international normalized ratio (INR) has reported in patients with nutritional deficiency, prolonged treatment, or renal or hepatic disease
Use with caution in patients with history of seizure disorder (especially in renal impairment, where drug levels may increase significantly)
Modify dose in renal impairment
Use with caution in patients with history of penicillin allergy
Prescribing the drug in the absence of proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria
Clostridioides difficile-associated diarrhea
- Clostridioides difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including ceftazidime products, and may range in severity from mild diarrhea to fatal colitis; treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile
- C. difficile produces toxins A and B, which contribute to the development of CDAD; hypertoxin- producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy
- CDAD must be considered in all patients who present with diarrhea following antibacterial use; careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents
- If CDAD is suspected or confirmed, ongoing antibacterial use not directed against C. difficile may need to be discontinued; appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated
Pregnancy & Lactation
Pregnancy category: B
Lactation: Drug excreted in breast milk; use with caution
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Third-generation cephalosporin with broad-spectrum gram-negative activity, including Pseudomonas; has lower efficacy against gram-positive organisms and higher efficacy against resistant organisms; arrests bacterial growth by binding to 1 or more penicillin-binding proteins, thereby, in turn, inhibiting final transpeptidation step of peptidoglycan synthesis in bacterial cell-wall synthesis and inhibiting cell-wall biosynthesis
Absorption
Peak plasma time: IM, 1 hr
Distribution
Widely distributed to body tissues and fluids, including aqueous humor, ascitic and prostatic fluids, and bone; penetrates CSF when meninges are inflamed
Protein bound: 5-24%
Metabolism
Not metabolized
Elimination
Half-life: 1-2 hr
Dialyzable: Hemodialysis, yes; peritoneal dialysis, yes
Excretion: Urine (80-90% as unchanged drug)
Administration
IV Incompatibilities
Additive: Amikacin, aminophylline, ciprofloxacin, gentamicin, ranitidine
Y-site: Amiodarone, amphotericin B cholesteryl complex, azithromycin, amsacrine, clarithromycin, cisatracurium(?), doxorubicin liposome, erythromycin lactobionate, fluconazole(?), idarubucin, midazolam, nicardipine (incompatible at ceftazidime 125 mg/mL but compatible at ceftazidime 10 mg/mL), pentamidine, propofol (incompatible at ceftazidime 125 mg/mL but compatible at ceftazidime 40 mg/mL), sagramostim(?), vancomycin(?), warfarin
IV/IM Administration
IV
- Direct injection: Inject over 3-5 minutes directly into vein or through tubing of running compatible infusion solution
- Infusion: Infuse intermittently over 15-30 minutes
IM
- Inject deeply
Storage
Store intact vials at room temperature, protected from light
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Tazicef intravenous - | 2 gram vial |  | |
| Tazicef intravenous - | 1 gram vial |  | |
| ceftazidime injection - | 1 gram vial |  | |
| ceftazidime injection - | 6 gram vial |  | |
| ceftazidime injection - | 2 gram vial |  | |
| ceftazidime injection - | 6 gram vial |  | |
| ceftazidime injection - | 2 gram vial |  | |
| ceftazidime injection - | 1 gram vial |  | |
| ceftazidime injection - | 6 gram vial |  | |
| Tazicef injection - | 6 gram vial |  | |
| Tazicef injection - | 1 gram vial |  | |
| Tazicef injection - | 2 gram vial |  | |
| Tazicef injection - | 2 gram vial |  |
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