Difference between revisions of "Ceftazidime"

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==General==
 
==General==
*Type:  
+
*Type: Third generation [[cephalosporin]]
*Dosage Forms:
+
*Dosage Forms: injectable solution, powder for injection
*Common Trade Names:  
+
*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==
 
==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==
 
==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==
 
==Special Populations==
*Pregnancy:
+
*Pregnancy: C; May use during pregnancy
*Lactation:
+
*Lactation: No known risk
 
*Renal Dosing
 
*Renal Dosing
 
**Adult
 
**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
 
**Pediatric
 +
***CrCl 30-50: Give q12h
 +
***CrCl 10-29: Give q24h
 +
***CrCl  <10: Give q48h
 +
***HD/PD: No supplement
 +
 
*Hepatic Dosing
 
*Hepatic Dosing
**Adult
+
**Adult: No adjustment
**Pediatric
+
**Pediatric: No adjustment
  
 
==Contraindications==
 
==Contraindications==
 
*Allergy to class/drug
 
*Allergy to class/drug
 +
*Caution:
 +
**Hypersensitivity to [penicillin]
 +
**Renal impairment
 +
**Concurrent nephrotoxic agent
 +
**Seizure disorder
 +
**Recent abx-associated colitis
  
 
==Adverse Reactions==
 
==Adverse Reactions==
 
===Serious===
 
===Serious===
 +
*[[Seizure]]
 +
*[[Agranulocytosis]]
 +
*[[Thrombocytopenia]]
 +
*[[Anemia]], hemolytic
 +
*[[Anaphylaxis]]
 +
*C. difficile-associated diarrhea
  
 
===Common===
 
===Common===
 +
*[[Diarrhea]]
 +
*[[Nausea]]/[[Vomiting]]
 +
*Abdominal pain
 +
*[[Rash]]
 +
*Pruritus
 +
*Urticaria
 +
*[[Headache]]
 +
*Dizziness
 +
*ALT, AST elevation
 +
*BUN, Cr elevation
  
 
==Pharmacology==
 
==Pharmacology==
*Half-life:  
+
*Half-life: 1.9h
*Metabolism:  
+
*Metabolism: Minimal
*Excretion:  
+
*Excretion: Urine primarily
*Mechanism of Action:
+
*Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis
 +
 
 +
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
 +
{| class="wikitable"
 +
| align="center" style="background:#f0f0f0;"|'''Group'''
 +
| align="center" style="background:#f0f0f0;"|'''Organism'''
 +
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
 +
|-
 +
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
 +
|-
 +
| ||[[Strep. Pneumoniae]]||'''S'''
 +
|-
 +
| ||[[Viridans strep]]||I
 +
|-
 +
| ||Strep. anginosus gp||X1
 +
|-
 +
| ||[[Enterococcus faecalis]]||R
 +
|-
 +
| ||[[Enterococcus faecium]]||X1
 +
|-
 +
| ||[[MSSA]]||I
 +
|-
 +
| ||[[MRSA]]||R
 +
|-
 +
| ||[[CA-MRSA]]||R
 +
|-
 +
| ||[[Staph. Epidermidis]]||I
 +
|-
 +
| ||[[C. jeikeium]]||R
 +
|-
 +
| ||[[L. monocytogenes]]||R
 +
|-
 +
| Gram Negatives||[[N. gonorrhoeae]]||I
 +
|-
 +
| ||[[N. meningitidis]]||I
 +
|-
 +
| ||[[Moraxella catarrhalis]]||'''S'''
 +
|-
 +
| ||[[H. influenzae]]||'''S'''
 +
|-
 +
| ||[[E. coli]]||'''S'''
 +
|-
 +
| ||[[Klebsiella]] sp||'''S'''
 +
|-
 +
| ||E. coli/Klebsiella ESBL+||R
 +
|-
 +
| ||E coli/Klebsiella KPC+||R
 +
|-
 +
| ||[[Enterobacter]] sp, AmpC neg||'''S'''
 +
|-
 +
| ||[[Enterobacter]] sp, AmpC pos||R
 +
|-
 +
| ||[[Serratia]] sp||'''S'''
 +
|-
 +
| ||Serratia marcescens||X1
 +
|-
 +
| ||[[Salmonella]] sp||'''S'''
 +
|-
 +
| ||[[Shigella]] sp||'''S'''
 +
|-
 +
| ||[[Proteus mirabilis]]||'''S'''
 +
|-
 +
| ||[[Proteus vulgaris]]||'''S'''
 +
|-
 +
| ||[[Providencia sp.]]||'''S'''
 +
|-
 +
| ||[[Morganella sp.]]||'''S'''
 +
|-
 +
| ||[[Citrobacter freundii]]||R
 +
|-
 +
| ||[[Citrobacter diversus]]||'''S'''
 +
|-
 +
| ||[[Citrobacter sp.]]||'''S'''
 +
|-
 +
| ||[[Aeromonas sp]]||'''S'''
 +
|-
 +
| ||[[Acinetobacter sp.]]||I
 +
|-
 +
| ||[[Pseudomonas aeruginosa]]||'''S'''
 +
|-
 +
| ||[[Burkholderia cepacia]]||'''S'''
 +
|-
 +
| ||[[Stenotrophomonas maltophilia]]||I
 +
|-
 +
| ||[[Yersinia enterocolitica]]||I
 +
|-
 +
| ||[[Francisella tularensis]]||X1
 +
|-
 +
| ||[[Brucella sp.]]||X1
 +
|-
 +
| ||[[Legionella sp.]]||R
 +
|-
 +
| ||[[Pasteurella multocida]]||X1
 +
|-
 +
| ||[[Haemophilus ducreyi]]||'''S'''
 +
|-
 +
| ||[[Vibrio vulnificus]]||X1
 +
|-
 +
| Misc||[[Chlamydophila sp]]||X1
 +
|-
 +
| ||[[Mycoplasm pneumoniae]]||X1
 +
|-
 +
| ||[[Rickettsia sp]]||X1
 +
|-
 +
| ||[[Mycobacterium avium]]||X1
 +
|-
 +
| Anaerobes||[[Actinomyces]]||X1
 +
|-
 +
| ||[[Bacteroides fragilis]]||R
 +
|-
 +
| ||[[Prevotella melaninogenica]]||'''S'''
 +
|-
 +
| ||[[Clostridium difficile]]||X1
 +
|-
 +
| ||[[Clostridium (not difficile)]]||'''S'''
 +
|-
 +
| ||[[Fusobacterium necrophorum]]||X1
 +
|-
 +
| ||[[Peptostreptococcus sp.]]||'''S'''
 +
|}
 +
 
 +
===Key===
 +
{{Template:Antibacterial Spectra Key}}
  
 
==See Also==
 
==See Also==
 
*[[Antibiotics (Main)]]
 
*[[Antibiotics (Main)]]
  
==Source==
+
==References==
 +
<references/>
  
<references/>
+
[[Category:Pharmacology]] [[Category:ID]]
[[Category:Drugs]]
 

Latest revision as of 22:02, 19 September 2019

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 Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep I
Strep. anginosus gp X1
Enterococcus faecalis R
Enterococcus faecium X1
MSSA I
MRSA R
CA-MRSA R
Staph. Epidermidis I
C. jeikeium R
L. monocytogenes R
Gram Negatives N. gonorrhoeae I
N. meningitidis I
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg S
Enterobacter sp, AmpC pos R
Serratia sp S
Serratia marcescens X1
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. S
Citrobacter freundii R
Citrobacter diversus S
Citrobacter sp. S
Aeromonas sp S
Acinetobacter sp. I
Pseudomonas aeruginosa S
Burkholderia cepacia S
Stenotrophomonas maltophilia I
Yersinia enterocolitica I
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida X1
Haemophilus ducreyi S
Vibrio vulnificus X1
Misc Chlamydophila sp X1
Mycoplasm pneumoniae X1
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces X1
Bacteroides fragilis R
Prevotella melaninogenica S
Clostridium difficile X1
Clostridium (not difficile) S
Fusobacterium necrophorum X1
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