Ceftazidime

Ceftazidime - Use | Dose | Side Effects

Ceftazidime is indicated for the treatment of the following infections in adults and children, including newborns:

  • Nosocomial pneumonia
  • Bronchopulmonary infections in patients with cystic fibrosis
  • Bacterial meningitis
  • Chronic suppurative otitis media
  • Malignant otitis externa
  • Complicated urinary tract infections
  • Complicated skin and soft tissue
  • Complicated intra-abdominal infections
  • Bone and joint infections
  • Peritonitis associated with dialysis in patients on continuous ambulatory peritoneal dialysis (CAPD).

Ceftazidime is used in the treatment of patients with bacteremia which is connected to or is suspected of having is associated with any of the above infections. Ceftazidime can be used in the treatment of patients with neutropenia and fever which are suspected to be caused by a bacterial infection. In severe neutropenia ceftazidime may use in combination with an aminoglycoside or other beta-lactam antibiotics. Ceftazidime can be used in peri operating prophylaxis of urinary tract infections in patients undergoing transurethral resection of the prostate (TURP). When choosing ceftazidime it should be consider its antibacterial spectrum of action, which is generally limited to a Gram-negative aerobic bacteria. Ceftazidime should be administered in conjunction with other antibacterial medicines whenever  range of possible causative bacteria does not match the range of its activities.

Warning and precautions

Do not use this medicine if:

  • You have a hypersensitivity to ceftazidime or a cephalosporin antibiotics such as: cefaclor (Raniclor), cefadroxil (Duricef), cefazolin (Ancef), cefdinir (Omnicef), cefditoren (Spectracef), cefpodoxime (Vantin), cefprozil (Cefzil), cefuroxime (Ceftin), cephalexin (Keflex), cephradine (Velosef).
  • Serious hypersensitivity reactions ( e.g., anaphylactic reactions ) on any beta-lactam antibiotics (penicillins , monobactams or carbapenems) in history.

As with other beta-lactam antibiotics have been reported, constitute serious hypersensitivity reactions sometimes leading to death. In case of severe allergic reactions to ceftazidime, it is necessary to immediately stop the use of the medicine and promptly take appropriate treatment measures. Before initiation of therapy ceftazidime should be carefully determine medical history of patient to see  whether he had no severe hypersensitivity reactions to ceftazidime, other cephalosporins, or any other beta-lactam antibiotic. Caution is advised in patients who have previously had allergic reaction to penicillin or beta-lactam antibiotics. Caution should be exercised if ceftazidime is given to patients with less severe hypersensitivity reactions to other beta-lactams antibiotics in history. Due to the limited spectrum of antibacterial action, it is not suitable as ceftazidime monotherapy in the treatment of some types of infections, unless the cause is not already established and well-known that is susceptible to ceftazidime, or there is a high probability that the most likely cause (agents) to be sensitive to ceftazidime. This is especially the case when considering treatment of patients with bacteremia, bacterial meningitis, skin and soft tissue and bone and joint infections. Furthermore, ceftazidime is susceptible to hydrolytic activity of several beta lactamase extended spectrum (ESBL). Therefore, when choosing ceftazidime for the treatment should be considered, and the prevalence of the microorganisms that produce ESBL. Colitis associated with the use of antibacterial medicines and pseudomembranous colitis have been reported in the application of almost all antibiotics, including ceftazidime, and by its can vary in severity from mild to life threatening. Therefore it is important to take into account the differential diagnosis of diarrhea in patients during and after treatment with ceftazidime. It is necessary to consider the discontinuation of ceftazidime and application specific remedy for treatment of colitis which is the causative agent of Clostridium difficile. You may not apply medicines that inhibit peristalsis. Aminoglycosides or potent diuretics ( e.g., furosemide ) may adversely affect the function of kidney. Ceftazidime is eliminated by the kidneys, therefore, the dose should be reduced depending on the degree of damage renal function. In patients with impaired renal function should be monitored closely efficacy and safety of the medicine. Occasionally its recorded the occurrence of neurological symptoms in patients with impaired renal function in which the dose of ceftazidime was reduced. Prolonged use of ceftazidime may result in overgrowth of nonsusceptible organisms in ceftazidime ( e.g., Enterococci , and fungi ) which may require cessation of therapy or introduction of appropriate additional measures. The permanent control of the patient's clinical condition is necessary. Ceftazidime does not interfere with the glycosuria assays based on enzymatic reactions, but there may be a slight interference (false-positive) with the methods of reduction of copper (Benedict 's, Fehling 's, Clinitest). Ceftazidime does not interfere with the test of determining the creatinine alkaline picrate method. Occurrence Coombs-positive results in this test 5 % of patients can be treated with ceftazidime interfere with the examination of the blood compatibility.

Use with other medicines (Interaction)

Interaction studies were performed only with furosemide and probenecid. Co-administration of high doses of ceftazidime with nephrotoxic medicines may adversely affect renal function. Chloramphenicol is the in vitro antagonistic effect with ceftazidime and other cephalosporins. The clinical significance of this observation is not known, but when the decision of concomitant administration ceftazidime and chloramphenicol, it should take into account the possibility of their antagonistic activity.

Pregnancy and lactation

There are limited data on the use of ceftazidime in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryonal/fetal development, parturition or postnatal development. Ceftazidime should be used during pregnancy only if the benefit of treatment exceeds the risk of medicine administration. Ceftazidime is excreted in human milk in low concentrations, but the application of therapeutic doses do not expect the effects of ceftazidime in infants. Cefaz can be administered during lactation.

Side effects

The most common side effects include eosinophilia, thrombocytosis, phlebitis or thrombophlebitis with intravenous application, and diarrhea, transient elevation of liver enzymes, maculopapular or rash, pain and/or inflammation after intramuscular administration, and positive Coombs test.

Overdose

An overdose may lead to neurological symptoms, including encephalopathy, and seizures coma. Symptoms of overdose can occur if dosage is not reduced appropriately in patients with renal impairment. Serum levels of ceftazidime can be reduced by hemodialysis or peritoneal dialysis.