Treatment of bone and joint infections caused by susceptible Staphylococcus aureus (oxacillin-susceptible strains only) Klebsiella, or Pseudomonas aeruginosa.
Intra-abdominal and Gynecologic Infections
Treatment of gynecologic infections (including endometritis, pelvic cellulitis, other infections of the female genital tract) caused by susceptible Escherichia coli.
Treatment of intra-abdominal infections (including peritonitis) caused by susceptible S. aureus (oxacillin-susceptible strains only), E. coli, or Klebsiella.
Treatment of polymicrobial intra-abdominal infections caused by susceptible aerobic and anaerobic bacteria and Bacteroides. Consider that many strains of B. fragilis are resistant; generally should not be used alone in serious intra-abdominal infections when this organism may be involved.
Meningitis and Other CNS Infections
Treatment of meningitis caused by susceptible H. influenzae, Neisseria meningitidis, Ps. aeruginosa, or Streptococcus pneumoniae in adults or children.
Ceftazidime in conjunction with an aminoglycoside considered a regimen of choice for treatment of meningitis caused by susceptible P. aeruginosa or susceptible Enterobacteriaceae† (e.g., E. coli, P. mirabilis, Enterobacter, S. marcescens).
Cefotaxime or ceftriaxone generally preferred when a third generation cephalosporin is indicated for treatment of meningitis caused by H. influenzae, N. meningitidis, or S. pneumoniae.
Respiratory Tract Infections
Treatment of respiratory tract infections (including pneumonia) caused by susceptible S. aureus (oxacillin-susceptible [methicillin-susceptible] strains only), S. pneumoniae, Citrobacter, Enterobacter, E. coli, Klebsiella, Proteus mirabilis, Pseudomonas (including Ps. aeruginosa), or Serratia.
For treatment of community-acquired pneumonia (CAP) caused by Ps. aeruginosa, ATS and IDSA recommend a combination regimen that includes an antipseudomonal β-lactam (cefepime, ceftazidime, aztreonam, imipenem, meropenem, piperacillin, ticarcillin) given in conjunction with ciprofloxacin, levofloxacin, or an aminoglycoside.
Septicemia
Treatment of septicemia caused by susceptible S. aureus (oxacillin-susceptible strains only), S. pneumoniae, Haemophilus influenzae, E. coli, Klebsiella, Ps. aeruginosa, or Serratia.
Skin and Skin Structure Infections
Treatment of skin and skin structure infections caused by susceptible S. aureus (oxacillin-susceptible strains only), S. pyogenes (group A β-hemolytic streptococci), Enterobacter, E. coli, Klebsiella, Proteus (including P. mirabilis), Ps. aeruginosa, or Serratia.
Urinary Tract Infections (UTIs)
Treatment of uncomplicated and complicated UTIs caused by susceptible Enterobacter, E. coli, Klebsiella, Proteus (including P. mirabilis), Ps. aeruginosa, or Serratia.
Burkholderia Infections
Treatment of septicemia or pulmonary infections caused by Burkholderia cepacia† (formerly Ps. cepacia); alone or in conjunction with an aminoglycoside. Co-trimoxazole considered drug of choice; ceftazidime, chloramphenicol, or imipenem are alternatives.
Treatment of severe melioidosis† caused by B. pseudomallei (formerly Ps. pseudomallei). Localized or mild disease may be effectively treated with a prolonged regimen of oral anti-infectives (e.g., co-trimoxazole with or without doxycycline). Severe illness usually treated with an initial parenteral regimen of ceftazidime, imipenem, or meropenem (some clinicians recommend that co-trimoxazole also be included, especially if the patient is septicemic) followed by prolonged maintenance with oral anti-infectives (e.g., co-trimoxazole with or without doxycycline). B. pseudomallei is difficult to eradicate (relapse of melioidosis is common). a
Otitis Externa
Treatment of malignant otitis externa† caused by Ps. aeruginosa.
Acute bacterial otitis externa localized in the external auditory canal may be effectively treated using topical anti-infectives (e.g., otic preparations of ciprofloxacin or ofloxacin), but malignant otitis externa is an invasive, potentially life-threatening infection (especially in immunocompromised patients such as those with diabetes mellitus or HIV infection) and requires prompt diagnosis and long-term treatment with parenteral anti-infectives (e.g., ceftazidime and/or ciprofloxacin).
Pseudomonas aeruginosa Infections
Generally considered a drug of choice for treatment of infections caused by Ps. aeruginosa, including acute exacerbations of bronchopulmonary Ps. aeruginosa infections in children and adults with cystic fibrosis.
In severe infections, especially in immunocompromised patients, concomitant use of ceftazidime and an aminoglycoside (e.g., amikacin, gentamicin, tobramycin) is recommended. Consider that ceftazidime-resistant strains of Ps. aeruginosa can emerge during therapy and superinfection with resistant strains has occurred.
Anti-infective therapy in patients with cystic fibrosis may result in clinical improvement and Ps. aeruginosa may be temporarily cleared from the sputum, but a bacteriologic cure is rarely obtained and should not be expected.
Vibrio Infections
Treatment of infections caused by Vibrio vulnificus†.
Optimum anti-infective therapy has not been identified; a tetracycline or third generation cephalosporin (e.g., cefotaxime, ceftazidime) is recommended. Because the case fatality rate associated with V. vulnificus is high, initiate anti-infective therapy promptly if indicated.
Empiric Therapy in Febrile Neutropenic Patients
Empiric treatment of presumed bacterial infections in febrile neutropenic adults or children†. Has been used alone or in conjunction with an aminoglycoside (e.g., amikacin, gentamicin, tobramycin).
Consider that gram-positive bacteria have become a predominant pathogen in febrile neutropenic patients and that ceftazidime is less active against gram-positives than many other cephalosporins and β-lactam antibiotics. An anti-infective active against staphylococci (e.g., vancomycin) probably should be used concomitantly if ceftazidime is used for empiric therapy.
Consult published protocols for the treatment of infections in febrile neutropenic patients for specific recommendations regarding selection of the initial empiric regimen, when to change the initial regimen, possible subsequent regimens, and duration of therapy in these patients. Consultation with an infectious disease expert knowledgeable about infections in immunocompromised patients also is advised.
Other cephalosporins or cephamycins (cefazolin, cefotetan, cefoxitin) are preferred drugs for perioperative prophylaxis. Ceftazidime and other third generation cephalosporins usually not used for perioperative prophylaxis since they are expensive, some are less active against staphylococci than cefazolin, they have a spectrum of activity wider than necessary for organisms encountered in elective surgery, and their use for prophylaxis promotes emergence of resistant organisms.
Dosage and Administration
Administration
Administer by intermittent IV injection or infusion or by deep IM injection. Also has been administered by continuous IV infusion†.
Has been administered intraperitoneally in dialysis solutions. Should not be administered by intra-arterial injection since arteriospasm and necrosis can occur.
The commercially available frozen ceftazidime injection in dextrose should be used only for IV infusion.
IV Injection
Reconstitution
For intermittent IV injection, reconstitute vials containing 500 mg, 1 g, or 2 g with 5.3 mL, 10, or 10 mL, respectively, of sterile water for injection to provide solutions containing approximately 100, 100, or 170mg/mL, respectively.
Shake vial after adding the diluent; carbon dioxide is released as drug dissolves and the solution will become clear within 1–2 minutes. When withdrawing a dose from reconstituted vials, consider that the solution may contain some carbon dioxide bubbles which should be expelled from the syringe before injection.
Rate of Administration
Inject appropriate dose of reconstituted solution into a vein over a period of 3–5 minutes or slowly into the tubing of a compatible IV solution.
IV Infusion
Reconstitution and Dilution
Reconstitute vials of containing 1 or 2 g of ceftazidime with 100 mL of sterile water for injection or compatible IV solution. Shake the vial after adding the diluent; carbon dioxide is released as the drug dissolves and the solution will become clear within 1–2 minutes. The appropriate dose of the drug should then be added to a compatible IV solution.
Reconsitute pharmacy bulk packages according to the manufacturer's directions and then further dilute in a compatible IV infusion solution prior to administration.
ADD-Vantage® vials labeled as containing 1 or 2 g of ceftazidime should be reconstituted according to the manufacturer’s directions.
Thaw the commercially available injection (frozen) at room temperature or in a refrigerator; do not force thaw by immersion in a water bath or by exposure to microwave radiation. A precipitate may have formed in the frozen injection, but should dissolve with little or no agitation after reaching room temperature. Discard thawed injection if an insoluble precipitate is present or if container seals or outlet ports are not intact. The injection should not be used in series connections with other plastic containers, since such use could result in air embolism from residual air being drawn from the primary container before administration of fluid from the secondary container is complete.
Rate of Administration
Intermittent IV infusions generally have been infused over 15–30 minutes in adults, neonates, and children.
If a Y-type administration set is used, the other solution flowing through the tubing should be discontinued while ceftazidime is being infused.
IM Injection
IM injections should be made deeply into a large muscle mass, such as the upper outer quadrant of the gluteus maximus or lateral part of the thigh.
Reconstitution
IM injections are prepared by adding 1.5 or 3 mL of sterile or bacteriostatic water for injection or 0.5 or 1% lidocaine hydrochloride injection to vials containing 500 mg or 1 g of ceftazidime, respectively, to provide solutions containing approximately 280 mg/mL.
Shake the vial after adding the diluent; carbon dioxide is released as the drug dissolves and the solution will become clear within 1–2 minutes. When withdrawing a dose from reconstituted vials, consider that the solution may contain some carbon dioxide bubbles which should be expelled from the syringe before injection.
Intraperitoneal Instillation
Reconstitute with sterile water for injection as for IV infusion and then further dilute in a compatible peritoneal dialysis solution to provide a solution containing 250 mg of ceftazidime in each 2 L of dialysis solution.
Dosage
Available as ceftazidime pentahydrate and as ceftazidime sodium; dosage expressed as anhydrous ceftazidime.
Pediatric Patients
General Pediatric Dosage in Neonates
IV
Neonates ≤4 weeks of age: manufacturer recommends 30 mg/kg every 12 hours.
Neonates <1 week of age: AAP recommends 50 mg/kg every 12 hours in those weighing ≤2 kg and 50 mg/kg every 8 or 12 hours in those weighing >2 kg.
Neonates 1–4 weeks of age: AAP recommends 50 mg/kg every 12 hours in those weighing <1.2 kg and 50 mg/kg every 8 hours in those weighing ≥1.2 kg.
General Pediatric Dosage in Children 1 Month to 12 Years of Age
IV
25–50 mg/kg every 8 hours. Use 50 mg/kg every 8 hours in immunocompromised children or children with cystic fibrosis.
AAP recommends 75–100 mg/kg daily in 3 equally divided doses for the treatment of mild to moderate infections or 125–150 mg/kg daily in 3 equally divided doses for the treatment of severe infections.
General Pediatric Dosage in Children >12 Years of Age
IV
Use usual adult dosage. (See Adult Dosage under Dosage and Administration.)
Meningitis
IV
Some clinicians recommend 100–150 mg/kg daily in 2 or 3 equally divided doses for neonates ≤7 days of age and 150 mg/kg daily in 3 divided doses in older neonates and children.
Because of a high rate of relapse, treatment duration should be ≥3 weeks for meningitis caused by gram-negative bacilli. In neonates, some clinicians recommend that treatment be continued for 2 weeks beyond the first sterile CSF culture or at least 3 weeks, whichever is longer.
Burkholderia Infections
Severe Melioidosis Caused by Burkholderia pseudomallei
IV
60 mg/kg daily in 2 equally divided doses recommended by some clinicians for children <2 months of age or 100 mg/kg daily in 3 equally divided doses for children ≥2 months of age. Concomitant co-trimoxazole or doxycycline may be indicated in septicemic or other severe cases.†
Continue initial parenteral regimen for at least 14 days and until there is clinical improvement. When appropriate, switch to an oral maintenance regimen (e.g., oral co-trimoxazole with or without oral doxycycline) and continue for at least 3–6 months to prevent recrudence or relapse. More prolonged oral maintenance therapy (up to 12 months) may be necessary, depending on the response to therapy and severity of initial illness.†
Empiric Therapy in Febrile Neutropenic Children
IV
50 mg/kg (maximum 2 g) every 8 hours has been used in pediatric patients ≥2 years of age.†
Adults
General Adult Dosage
Less Severe Infections
IV or IM
1 g every 8–12 hours.
Severe or Life-threatening Infections
IV
2 g every 8 hours, especially in immunocompromised patients.
Bone and Joint Infections
IV
2 g every 12 hours.
Intra-abdominal and Gynecologic Infections
Serious Infections
IV
2 g every 8 hours.
Meningitis
IV
2 g every 8 hours. Duration of treatment is ≥3 weeks for meningitis caused by susceptible gram-negative bacilli.
Respiratory Tract Infections
Uncomplicated Pneumonia
IV or IM
0.5–1 g every 8 hours.
Pseudomonas Lung Infections in Cystic Fibrosis Patients
IV
30–50 mg/kg every 8 hours (up to 6 g daily).
Clinical improvement may occur, but bacteriologic cures should not be expected in patients with chronic respiratory disease and cystic fibrosis.
Skin and Skin Structure Infections
Mild Infections
IV or IM
0.5–1 g every 8 hours.
Urinary Tract Infections (UTIs)
Uncomplicated Infections
IV or IM
250 mg every 12 hours.
Complicated Infections
IV or IM
500 mg every 8–12 hours.
Burkholderia Infections
Severe Melioidosis Caused by Burkholderia pseudomallei
IV
40 mg/kg every 8 hours recommended by US Army Medical Research Institute of Infectious Diseases (USAMRIID). Others recommend 2 g every 8 hours (up to 6 g daily) or 50 mg/kg (up to 2 g) every 6 hours. Concomitant co-trimoxazole or doxycycline may be indicated in septicemic or other severe cases.†
Continue initial parenteral regimen for at least 14 days and until there is clinical improvement. When appropriate, switch to an oral maintenance regimen (e.g., oral co-trimoxazole with or without oral doxycycline) and continue for at least 3–6 months to prevent recrudence or relapse. More prolonged oral maintenance therapy (up to 12 months) may be necessary, depending on the response to therapy and severity of initial illness.†
Prescribing Limits
Pediatric Patients
Maximum 6 g daily.
Adults
Maximum 6 g daily.
Special Populations
Hepatic Impairment
Dosage adjustments not required unless renal function also impaired.
Renal Impairment
Reduce dosage in patients with Clcr ≤50 mL/minute.
Manufacturers recommend that adults with Clcr ≤50 mL/minute receive an initial loading dose of 1 g and a maintenance dosage based on Clcr. (See Table.)
Maintenance Dosage for Adults with Renal Impairment
Clcr (mL/minute)
Dosage
31–50
1 g every 12 h
16–30
1 g every 24 h
6–15
500 mg every 24 h
<5
500 mg every 48 h
Patients with renal impairment and severe infections who would generally receive 6 g daily if renal function were normal: increase dosage in table by 50% or dosing interval may be increased appropriately.
Patients undergoing hemodialysis: given an initial loading dose of 1 g followed by 1 g after each hemodialysis period.
Patients undergoing intraperitoneal dialysis or CAPD: given an initial loading dose of 1 g followed by 500 mg every 24 hours.
Geriatric Patients
Cautious dosage selection because of age-related decreases in renal function. (See Renal Impairment under Dosage and Administration.)
Superinfection/Clostridium difficile-associated Diarrhea and Colitis (CDAD)
Possible emergence and overgrowth of nonsusceptible organisms with prolonged therapy. Careful observation of the patient is essential. Institute appropriate therapy if superinfection occurs.
Treatment with anti-infectives alters normal colon flora and may permit overgrowth of Clostridium difficile. C. difficile-associated diarrhea and colitis (CDAD; also known as antibiotic-associated diarrhea and colitis or pseudomembranous colitis) has been reported with nearly all anti-infectives, including ceftazidime, and may range in severity from mild diarrhea to fatal colitis. Hypertoxin producing strains of C. difficile are associated with increased morbidity and mortality since they may be refractory to anti-infectives and colectomy may be required.
Consider CDAD if diarrhea develops and manage accordingly. Careful medical history is necessary since CDAD has been reported to occur as late as 2 months or longer after anti-infective therapy is discontinued.
If CDAD is suspected or confirmed, the anti-infective may need to be discontinued. Some mild cases of CDAD may respond to discontinuance alone. Manage moderate to severe cases with fluid, electrolyte, and protein supplementation, anti-infective therapy active against C. difficile (e.g., oral metronidazole or vancomycin), and surgical evaluation when clinically indicated.
Neurotoxicity
Possibility of seizures, encephalopathy, coma, asterixis, neuromuscular excitability, and myoclonia if inappropriately high dosage used in patients with renal impairment. (See Renal Impairment under Cautions.)
Sensitivity Reactions
Hypersensitivity Reactions
Possible hypersensitivity reactions, including rash (maculopapular or erythematous), pruritus, fever, eosinophilia, urticaria, anaphylaxis, erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis.
If an allergic reaction occurs, discontinue and institute appropriate therapy as indicated (e.g., epinephrine, corticosteroids, maintenance of an adequate airway and oxygen).
Cross-hypersensitivity
Partial cross-sensitivity among cephalosporins and other β-lactam antibiotics, including penicillins and cephamycins.
Prior to initiation of therapy, make careful inquiry concerning previous hypersensitivity reactions to cephalosporins, penicillins, or other drugs. Cautious use recommended in individuals hypersensitive to penicillins: avoid use in those who have had an immediate-type (anaphylactic) hypersensitivity reaction and administer with caution in those who have had a delayed-type (e.g., rash, fever, eosinophilia) reaction.
General Precautions
History of GI Disease
Use with caution in patients with a history of GI disease, particularly colitis. (See Superinfection/Clostridium difficile-associated Diarrhea and Colitis under Cautions.)
Prolonged PT
Possibility of prolonged PT.
Monitor PT in patients at risk, including those with renal or hepatic impairment, poor nutritional state, receiving prolonged therapy, or stabilized on anticoagulant therapy. Administer vitamin K when indicated.
Selection and Use of Anti-infectives
To reduce development of drug-resistant bacteria and maintain effectiveness of ceftazidime and other antibacterials, use only for treatment or prevention of infections proven or strongly suspected to be caused by susceptible bacteria.
When selecting or modifying anti-infective therapy, use results of culture and in vitro susceptibility testing. In the absence of such data, consider local epidemiology and susceptibility patterns when selecting anti-infectives for empiric therapy.
Resistance in Gram-negative Bacteria
Resistance caused by inducible type I β-lactamases can develop in some gram-negative bacilli (e.g., Enterobacter, Pseudomonas, Serratia) during treatment, leading to clinical failure in some cases.
When treating infections caused by these bacteria, perform periodic in vitro susceptibility testing when clinically appropriate. If patient fails to respond to monotherapy, an aminoglycoside or similar agent should be considered.
Risk of Distal Necrosis
Possibility of distal necrosis after inadvertent intra-arterial administration.
Sodium Content
Vials, pharmacy bulk packages, and ADD-Vantage® vials contain ceftazidime admixed with sodium carbonate to facilitate dissolution. These preparations contain approximately 54 mg (2.3 mEq) of sodium per g of ceftazidime.
Specific Populations
Pregnancy
Category B.
Lactation
Distributed into milk in low concentrations; use with caution.
Geriatric Use
No overall differences in safety and efficacy in those ≥65 years of age compared with younger adults, but the possibility of increased sensitivity in some geriatric individuals cannot be ruled out.
Substantially eliminated by kidneys; risk of toxicity may be greater in those with impaired renal function. Select dosage with caution and assess renal function periodically because of age-related decreases in renal function. (See Renal Impairment under Dosage and Administration.)
Hepatic Impairment
Pharmacokinetics not affected.
Renal Impairment
Possible decreased clearance and increased serum half-life.
Neurotoxicity reported in some patients with renal impairment who received dosage inappropriately high for their renal status. (See Neurotoxicity under Cautions.)
Dosage adjustments necessary in patients with Clcr ≤50 mL/minute. See Renal Impairment under Dosage and Administration.
Common Adverse Effects
GI effects, hypersensitivity reactions, local reactions at IV injection sites.
No appreciable effect on pharmacokinetics of ceftazidime
Tests for glucose
Possible false-positive reactions in urine glucose tests using Clinitest®, Benedict’s solution, or Fehling’s solution
Use glucose tests based on enzymatic glucose oxidase reactions (e.g., Clinistix®, Tes-Tape®)
Pharmacokinetics
Absorption
Bioavailability
Not absorbed from GI tract; must be given parenterally.
Following IM administration, peak serum concentrations attained in approximately 1 hour. May be absorbed more slowly in women than in men following IM injection into the gluteus maximus or vastus lateralis. In women, peak serum concentrations may be lower following IM injection into the gluteus maximus than into the vastus lateralis.
In patients with end-stage chronic renal failure who receive a single dose of the drug via an intraperitoneal catheter, peak serum concentrations attained 2.75 hours after the dose.
Distribution
Extent
Widely distributed into body tissues and fluids including the gallbladder, bone, bile, skeletal muscle, prostatic tissue, endometrium, myometrium, heart, skin, adipose tissue, aqueous humor, and sputum, and pleural, peritoneal, synovial, ascitic, lymphatic, and blister fluids.
Generally diffuses into CSF following IV administration; CSF concentrations higher in patients with inflamed meninges than in those with uninflamed meninges.
Distributed into bile, but biliary concentrations following IM or IV administration may be lower than concurrent serum concentrations.
Crosses the placenta and is distributed into milk.
Plasma Protein Binding
5–24%.
Elimination
Metabolism
Not metabolized.
Elimination Route
Eliminated unchanged principally in urine by glomerular filtration.
80–90% of a dose eliminated in urine within 24 hours.
Half-life
Adults with normal renal and hepatic function: distribution half-life 0.1–0.6 hours and elimination half-life 1.4–2 hours.
Neonates: 2.2–4.7 hours.
Children 1–12 months of age: 2 hours.
Special Populations
Patients with impaired hepatic function: serum half-life only slightly prolonged.
Patients with impaired renal function: serum concentrations higher and serum half-life prolonged. Serum half-life ranges from 9.4–10.3 hours in those with Clcr 13–27 mL/minute and 11–35 hours in those with Clcr<10 mL/minute.
Stability
Storage
Parenteral
Powder for Injection or Infusion
15–30° C; protect from light.
Powder for injection and solutions may darken; does not indicate loss of potency.
Reconstituted IV solutions prepared using sterile water, IV solutions that have been further diluted to 1–40 mg/mL in a compatible IV solution, and IV solutions prepared from ADD-Vantage® are stable for 12 hours at room temperature or 3 days under refrigeration.
IM solutions containing 280 mg/mL prepared using sterile or bacteriostatic water or 0.5 or 1% lidocaine hydrochloride are stable for 12 hours at room temperature or 73days under refrigeration.
Injection (Frozen) for Infusion
-20° C or lower. After thawing, store up to 24 hours at room temperature (25°C) or up to 7 days under refrigeration.
Do not refreeze after thawing.
Compatibility
For information on systemic interactions resulting from concomitant use, see Interactions.
Parenteral
Solution Compatibility
Less stable in sodium bicarbonate injection than in other IV solutions; sodium bicarbonate not recommended as a diluent.
Based on spectrum of activity, classified as a third generation cephalosporin. Usually less active in vitro against susceptible staphylococci than first generation cephalosporins; has an expanded spectrum of activity against gram-negative bacteria compared with first and second generation cephalosporins.
Usually bactericidal.
Like other β-lactam antibiotics, antibacterial activity results from inhibition of bacterial cell wall synthesis.
Spectrum of activity of ceftazidime resembles that of ceftizoxime, cefotaxime, and ceftriaxone. However, ceftazidime more active against Pseudomonas than most other currently available parenteral third generation cephalosporins and less active against anaerobes and gram-positive aerobic cocci than these drugs.
Gram-positive aerobes: active in vitro and in clinical infections against S. aureus (including β-lactamase-producing strains), S. pneumoniae, S. pyogenes (group A β-hemolytic streptococci), and S. agalactiae (group B streptococci). Oxacillin-resistant (methicillin-resistant) staphylococci and enterococci (e.g., Enterococcus faecalis) are resistant.
Gram-negative aerobes: active in vitro and in clinical infections against Citrobacter (including C. freundii, C. diversus), Enterobacter (including E. aerogenes, E. cloacae), E. coli, H. influenzae (including ampicillin-resistant strains), Klebsiella (including K. pneumoniae), Neisseria meningitidis, Proteus mirabilis, P. vulgaris, Pseudomonas (including Ps. aeruginosa), and Serratia. Also active in vitro against Acinetobacter, H. parainfluenzae, Morganella morganii, N. gonorrhoeae, Providencia (including P. rettgeri), Salmonella, Shigella, and Yersinia enterocolitica.
Anaerobes: active in vitro and in clinical infections against Bacteroides; many strains of B. fragilis are resistant. Also active in vitro against Clostridium (except C. difficile), Peptococcus, and Peptostreptococcus.
Strains of staphylococci resistant to penicillinase-resistant penicillins (oxacillin-resistant [methicillin-resistant] staphylococci) should be considered resistant to ceftazidime, although results of in vitro susceptibility tests may indicate that the organisms are susceptible to the drug.
Importance of completing full course of therapy, even if feeling better after a few days.
Advise patients that skipping doses or not completing the full course of therapy may decrease effectiveness and increase the likelihood that bacteria will develop resistance and will not be treatable with ceftazidime or other antibacterials in the future.
Advise patients that diarrhea is a common problem caused by anti-infectives and usually ends when the drug is discontinued. Importance of contacting a clinician if watery and bloody stools (with or without stomach cramps and fever) occur during or as late as 2 months or longer after the last dose.
Importance of women informing clinician if they are or plan to become pregnant or plan to breast-feed.
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.
Importance of informing patients of other important precautionary information. (See Cautions.)
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
† Use is not currently included in the labeling approved by the US Food and Drug Administration.
Remember, keep this and all other medicines out of the reach of children,
never share your medicines with others, and use this medication only for the indication prescribed.
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