Paul A. Pham Pharm.D. and John G. Bartlett M.D.
Available formulation in Zambia: Powder for injection: 250 mg (as pentahydrate) in vial.
- Highly effective against many strains of Pseudomonas aeruginosa. Also active against Klebsiella, Serratia, Proteus, E.coli, and Enterobacter spp.
- Ventilator associated pneumonia: ceftazidime 1-2 gm IV q8h
- Pseudomonas pneumonia: ceftazidime 2gm IV q8h (plus gentamicin)
Zambia Information Author: Paul A. Pham Pharm.D.
- Lower respiratory tract infections including pneumonia caused by P. aeruginosa and other Pseudomonas spp.; H. influenzae; Klebsiella spp.; Enterobacter spp.; P. mirabilis; E. coli; Serratia spp.; Citrobacter spp.; S. pneumoniae; and MSSA. (cefotaxime or ceftriaxone preferred for S. pneumoniae)
- Skin and skin-structure infections caused by P. aeruginosa; Klebsiella spp.; E. coli; Proteus spp., including P. mirabilis and indole-positive Proteus; Enterobacter spp.; Serratia spp.; MSSA; and S. pyogenes
- Complicated and uncomplicated urinary tract infections caused by P. aeruginosa; Enterobacter spp.; Proteus spp., including P. mirabilis and indole-positive Proteus; Klebsiella spp.; and E. coli
- Septicemia caused by P. aeruginosa, Klebsiella spp., H. influenzae,E. coli, Serratia spp., S. pneumoniae, and MSSA (cefotaxime or ceftriaxone preferred for )
- Bone and joint infections caused by P. aeruginosa, Klebsiella spp., Enterobacter spp., and MSSA
- Gynecologic infections (endometritis, pelvic cellulitis, and other GYN infections) caused by E. coli
- Intra-abdominal Infections, including peritonitis caused by , Klebsiella spp., and MSSA and polymicrobial infections caused by aerobic and anaerobic organisms (in combination with metronidazole)
- Central nervous system infections including meningitis, caused by H. influenzae and N. meningitidis,P. aeruginosa and S. pneumoniae (cefotaxime or ceftriaxone preferred for S. pneumoniae)
- Shunt Infections
- Diabetic foot infection (in combination with clindamycin)
|Fortaz||Ceftazidime||GlaxoSmithKline and generic manufacturer||IV or IM|
||IV or IM|
|Tazicef||Ceftazidime ||Hospira and other generic manufacturers||IV or IM |
||IV or IM |
||IV or IM |
*Prices represent cost per unit specified and are representative of "Average Wholesale Price" (AWP).
AWP Prices were obtained and gathered by Lakshmi Vasist Pharm D using the Red Book, manufacturer's
information, and the McKesson database.
^Dosage is indicated in mg unless otherwise noted.
- Mild to moderate infections: 1gm IV q8-12h.
- Uncomplicated UTI : 500 mg IV q12h.
- Complicated UTI: 500mg IV q8h-q12h.
- Severe infections or meningitis: 2 gm IV q8 (8gm/day max).
- Bone and joint infections: 2 gm IV q12h.
P. aeruginosa pneumonia in CF pts: 2 gm IV q6h to q8h.
GFR >30-50 ml/min: 1gm q12h (2gm q12h for CNS or severe infections); GFR 10-29 ml/min: 1gm q24h (2gm q24 for CNS or severe infections).
0.5Gm q24-48h (1gm q24h for CNS or severe infections).
1 Gm loading, 1 Gm post-dialysis.
0.5-1.0 Gm loading, 250mg per each 2 Liter of dialysate exchange per day.
CVVH: 1-2 gm q12h. CVVHD with flow rate 1.5-2.5L/hr: 1-2gm q12h (2gm q12h for severe and CNS infections). CVVHD with flow rate 1 L/hr: 1-2 gm q24h (2gm q24h for severe and CNS infections).
- Phlebitis at infusion sites
- Allergic reactions (cross-reaction in PCN-allergic patients lower compared to 1st and 2nd generation cephalosporin)
Diarrhea and colitis
- Positive Coombs' test.
Probenecid:increased in ceftazidime serum concentration due to inhibition of tubular secretion by probenecid. No dose adjustment needed; co-administer with caution in renal insufficiency.
- Hemolytic anemia
- CNS: convulsions (high dose with renal failure), confusion, disorientation, and hallucinations
- Drug fever
Neutropenia and thrombocytopenia
- Interstitial nephritis
- MIC breakpoint for gram-negative non-lactose fermenters including P. aeruginosa is 8 mcg/mL.
- MIC breakpoint for Enterobacteriaceae: < or equal 4 mcg/mL (sensitive); 8 mcg/mL (intermediate); > or equal 16 mcg/mL (resistant).
Parenteral 3rd generation cephalosporin with good P. aeruginosa activity but resistance rates are up 20-25%. Acinetobacter is showing increasing resistance to ceftazidime (60-70% resistant). Cefepime is comparable to ceftazidime against GNB including P. aeruginosa but has better activity vs gram-positive cocci.