CEFIZOX IN DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for CEFIZOX IN DEXTROSE 5% IN PLASTIC CONTAINER (CEFIZOX IN DEXTROSE 5% IN PLASTIC CONTAINER).
Ceftizoxime is a third-generation cephalosporin antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell lysis and death. It has broad-spectrum activity against gram-positive and gram-negative bacteria.
| Metabolism | Ceftizoxime is not significantly metabolized; it is excreted unchanged primarily via renal glomerular filtration and tubular secretion. |
| Excretion | Renal: 80–90% unchanged via glomerular filtration and tubular secretion. Biliary/fecal: <10%. |
| Half-life | 1.5–2 hours in normal renal function; extends to 20–30 hours in ESRD. Dose adjustment required for CrCl <50 mL/min. |
| Protein binding | 85% primarily to albumin. |
| Volume of Distribution | 0.2–0.3 L/kg; indicates distribution primarily in extracellular fluid. |
| Bioavailability | IM: ~100%. |
| Onset of Action | IV: Immediate; IM: 30–60 minutes. |
| Duration of Action | 6–8 hours for susceptible infections; dosing every 6–12 hours based on severity and renal function. |
| Molecular Weight | 580.57 |
1-2 g IV every 8-12 hours; maximum 12 g/day
| Dosage form | INJECTABLE |
| Renal impairment | CrCl 50-79 mL/min: 1-2 g every 12 hours; CrCl 30-49 mL/min: 1-2 g every 18 hours; CrCl 10-29 mL/min: 1-2 g every 24 hours; CrCl <10 mL/min: 0.5-1 g every 24 hours |
| Liver impairment | No specific adjustment required; use with caution in severe hepatic impairment |
| Pediatric use | Neonates: 50 mg/kg IV every 12 hours; Infants and children: 50 mg/kg IV every 8 hours; maximum 2 g per dose |
| Geriatric use | Initiate at lower end of dosing range; adjust dose based on renal function |
| 1st trimester | Ceftizoxime crosses the placenta. Animal studies have not shown reproductive toxicity. Use only if clearly needed. |
| 2nd trimester | Ceftizoxime crosses the placenta. No evidence of teratogenicity. Use only if clearly needed. |
| 3rd trimester | Ceftizoxime crosses the placenta. Use only if clearly needed. Consider risk of neonatal infection. |
Clinical note
Comprehensive clinical and safety monograph for CEFIZOX IN DEXTROSE 5% IN PLASTIC CONTAINER (CEFIZOX IN DEXTROSE 5% IN PLASTIC CONTAINER).
| Placental transfer | Ceftizoxime crosses the placenta, achieving fetal serum concentrations of 20-50% of maternal levels. |
| Breastfeeding | Ceftizoxime is excreted into human milk in low concentrations. It is unlikely to cause adverse effects in the nursing infant. Caution with diarrhea or candidiasis. |
■ FDA Black Box Warning
No FDA black box warning.
| Serious Effects |
Hypersensitivity to ceftizoxime or other cephalosporins
| Precautions | Hypersensitivity reactions, including anaphylaxis, may occur, especially in patients with a history of penicillin allergy., Clostridium difficile-associated diarrhea (CDAD) may occur and range from mild diarrhea to fatal colitis., Dosage adjustment is required in patients with renal impairment., Prolonged use may result in superinfection with resistant organisms. |
| Food/Dietary | No specific food interactions. Avoid alcohol due to risk of disulfiram-like reaction (nausea, vomiting, headache, flushing). |
| Clinical Pearls |
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| Lactation Rating |
| L2 - Probably Compatible |
| Teratogenic Risk | Ceftizoxime is a cephalosporin antibiotic classified as FDA Pregnancy Category B. Animal studies have not demonstrated fetal risk, and there are no adequate and well-controlled studies in pregnant women. However, cephalosporins are generally considered safe in pregnancy. There is no known teratogenic risk in the first trimester; use in the second and third trimesters is also considered low risk, but caution is advised due to potential for altered pharmacokinetics. |
| Fetal Monitoring | Monitor maternal renal function, as ceftizoxime is primarily renally excreted and pregnancy-induced increases in glomerular filtration rate may affect clearance. Monitor for signs of hypersensitivity or superinfection. Fetal monitoring is not routinely required, but ultrasound may be considered if prolonged high-dose therapy is needed. |
| Fertility Effects | No specific fertility studies in humans. Animal studies have not shown impaired fertility. Ceftizoxime is not known to adversely affect reproductive function. |
| Cefizox (ceftizoxime) is a third-generation cephalosporin with poor activity against Enterococcus and Pseudomonas aeruginosa. In dextrose 5% solution, monitor for infusion reactions, especially in patients with renal impairment. For empiric therapy of intra-abdominal infections, consider adding metronidazole for anaerobic coverage. Use with caution in penicillin-allergic patients due to ~10% cross-reactivity. |
| Patient Advice | This medication is given intravenously; report any pain, redness, or swelling at the injection site. · Notify your healthcare provider if you develop a rash, itching, or difficulty breathing, which may indicate an allergy. · Diarrhea, especially watery or bloody, may occur; contact your doctor if severe or persistent. · Avoid alcohol during treatment and for at least 48 hours after the last dose to prevent disulfiram-like reactions. · Tell your doctor if you have kidney disease, as dose adjustments may be needed. |