Ceftazidime

Indications
 Parenteral
Pseudomonal lung infections in cystic fibrosis
Adult: 90-150 mg/kg/day in 3 divided doses via IM or IV inj or IV infusion, up to 9 g/day. Doses >1 g should be given via IV route.
Max Dosage: 9 g daily. Doses >1 g should be administered IV.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.

Parenteral
Prophylaxis of surgical infection in patients undergoing prostate surgery
Adult: 1 g at induction of anesth repeated if necessary upon removal of catheter.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.

Parenteral
Biliary tract infections
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.

Parenteral
Bone and joint infections
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.

Parenteral
Infections in immunocompromised patients
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.

Parenteral
Meningitis
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.

Parenteral
Peritonitis
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.

Parenteral
Pneumonia
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.

Parenteral
Skin infections
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.

Parenteral
Melioidosis
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.

Parenteral
Upper respiratory tract infections
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.

Parenteral
Endophthalmitis
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.

Parenteral
Urinary tract infections
Adult: 1-6 g daily in divided doses every 8 or 12 hr as deep IM, slow IV Inj over 3-5 min or infusion for up to 30 min.
Child: 30-100 mg/kg/day in 2 or 3 divided doses increased up to 150 mg/kg daily in severe cases. Neonates and infants ≤2 mth: 25-60 mg/kg/day in 2 divided doses. Max dose: 6 g daily in divided doses.
Elderly: Max dose: 3 g daily.
Renal impairment: Loading dose: 1 g; maintenance doses based on CrCl. May need to increase doses by 50% in severe infections. Peritoneal dialysis: Loading dose is followed by 500 mg every 24 hr; may add ceftazidime to the dialysis fluid (usually 125-250 mg for 2 litres of dialysis fluid). Haemodialysis: Admin loading dose then 0.5-1 g after each dialysis period.
CrCl (ml/min)Dosage Recommendation
31-501 g every 12 hr.
16-301 g every 24 hr.
6-15500 mg every 24 hr.
<5500 mg every 48 hr.


Special Populations: Renal impairment: 1 g loading dose followed by a maintenance dose based on patients creatinine clearance. CrCl: 31-50 mL/min: 1 g every 12 hrs; 16-30 mL/min: 1 g every 12 hrs; 6-15 mL/min: 0.5 g every 24 hrs; <5 mL/min: 0.5 g every 48 hrs. Increase dose by 50% in severe infections. Patients undergoing peritoneal dialysis: 1 g loading dose followed by 500 mg every 24 hrs. Patients undergoing haemodialysis: 1 g loading dose repeated after each dialysis period.
Contraindications
 Hypersensitivity to cephalosporins.
Warnings / Precautions
 History of penicillin allergy; severe renal impairment; pregnancy, lactation.
Adverse Reactions
 Hypersensitivity, dizziness, diarrhoea, nausea, vomiting, renal impairment, rash, erythema multiforme, thrombocytopaenia, superinfection, phloebitis and thrombophloebitis at the site of injection.
Potentially Fatal: Anaphylactic reactions, nephrotoxicity, pseudomembranous colitis.
Drug Interactions
 Probenecid may decrease ceftazidime elimination time.
Potentially Fatal: Furosemide and aminoglycosides may increase nephrotoxicity.
See Below for More ceftazidime Drug Interactions
Lab Interactions
 False-positives for Coombs' test and urinary glucose.
Mechanism of Actions
 Ceftazidime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Absorption: Peak plasma concentrations after 1 hr (IM), 5 min (IV bolus).
Distribution: Widely distributed in body tissues and fluids; CSF (therapeutic concentrations when meninges are inflamed). Crosses the placenta and enters breast milk. Protein-binding: 10%
Excretion: Mainly by the kidneys via the urine by glomerular filtration (80-90% as unchanged drug within 24 hr); passively excreted in bile but only a small proportion is eliminated. Clearance enhanced in cystic fibrosis; 2 hr (elimination half-life), prolonged in neonates and renal impairment.
Storage Conditions
 Parenteral: Store at 15-30°C.
ATC Classification
 J01DD02 - ceftazidime ; Belongs to the class of third-generation cephalosporins. Used in the systemic treatment of infections.
Storage
 Parenteral: Store at 15-30°C.
Available As
  • Ceftazidime 1 gm
  • Ceftazidime 1000 mg
  • Ceftazidime 125 mg
  • Ceftazidime 2000 mg
  • Ceftazidime 250 mg
  • Ceftazidime 500 mg

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