CEFTAZIDIME IN DEXTROSE CONTAINER
Clinical safety rating: safe
Probenecid may decrease cephalosporin excretion May cause diarrhea including Clostridium difficile-associated diarrhea.
Ceftazidime is a third-generation cephalosporin antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), thereby inhibiting transpeptidation and autolysin inhibition, leading to cell lysis and death.
| Metabolism | Ceftazidime is not metabolized; it is excreted unchanged primarily by the kidneys via glomerular filtration. |
| Excretion | Renal: 80-90% unchanged drug via glomerular filtration; biliary: <1%; fecal: <1% |
| Half-life | 1.9 hours (normal renal function); prolonged to 22-30 hours in ESRD |
| Protein binding | 17% bound to albumin |
| Volume of Distribution | 0.21 L/kg (adults); increased to 0.3-0.4 L/kg in neonates |
| Bioavailability | IV: 100%; IM: 100% |
| Onset of Action | IV: Immediate (within 5 minutes); IM: 30-60 minutes |
| Duration of Action | 6-8 hours (normal renal function); up to 24 hours in severe renal impairment |
| Molecular Weight | 636.6 |
1-2 g intravenously every 8 hours.
| Dosage form | INJECTABLE |
| Renal impairment | For CrCl 31-50 mL/min: 1 g every 12 hours. CrCl 16-30 mL/min: 1 g every 24 hours. CrCl 6-15 mL/min: 500 mg every 24 hours. CrCl <5 mL/min: 500 mg every 48 hours. |
| Liver impairment | No dosage adjustment required for hepatic impairment. |
| Pediatric use | Neonates (0-4 weeks): 30 mg/kg every 12 hours. Infants and children (1 month-12 years): 30-50 mg/kg every 8 hours, not to exceed 6 g/day. |
| Geriatric use | Dose based on renal function; use lower end of dosing range due to age-related renal decline. |
| 1st trimester | No adequate human studies; animal studies show no risk; use only if clearly needed. |
| 2nd trimester | No evidence of harm in human studies; crosses placenta; use with caution. |
| 3rd trimester | Generally considered safe; used for intra-amniotic infections; monitor for neonatal effects. |
Clinical note
Probenecid may decrease cephalosporin excretion May cause diarrhea including Clostridium difficile-associated diarrhea.
| FDA category | Human |
| Placental transfer | Crosses placenta; achieves therapeutic levels in fetal serum and amniotic fluid. |
| Breastfeeding | Enters breast milk in low concentrations; considered compatible; monitor infant for diarrhea, candidiasis. |
■ FDA Black Box Warning
None explicitly required by FDA; however, caution is advised for patients with hypersensitivity to cephalosporins, penicillins, or other beta-lactams.
| Common Effects | Diarrhea |
| Serious Effects |
Hypersensitivity to ceftazidime or any cephalosporinHistory of severe immediate hypersensitivity reaction to penicillins or other beta-lactams
| Precautions | Hypersensitivity reactions, including anaphylaxis, especially in patients with a history of penicillin allergy., Dose adjustment required in renal impairment; risk of neurotoxicity (seizures) with high doses or in renal failure., Clostridioides difficile-associated diarrhea (CDAD) may occur., Prolonged use may result in superinfection with resistant organisms., Incomplete cross-resistance with other cephalosporins; some ESBL-producing organisms may be resistant. |
| Food/Dietary |
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| Lactation Rating | L2 |
| Teratogenic Risk | FDA Pregnancy Category B. Animal studies have not demonstrated fetal risk. No adequate and well-controlled studies in pregnant women; should be used during pregnancy only if clearly needed. In vitro studies and clinical experience have not shown teratogenic effects. |
| Fetal Monitoring | Monitor maternal renal function (serum creatinine, BUN) and hepatic function (AST, ALT) periodically during prolonged therapy. Observe for signs of hypersensitivity or adverse reactions in both mother and fetus. Fetal heart rate monitoring is not routinely required but consider if maternal infection is severe. |
| Fertility Effects | No known adverse effects on fertility based on animal studies. No human data available. No evidence of impaired fertility or reproductive performance. |
| No specific food interactions. However, avoid alcohol consumption during therapy due to potential disulfiram-like reaction (nausea, vomiting, headache). |
| Clinical Pearls | Ceftazidime in dextrose container is a pre-mixed, ready-to-use solution for IV administration. It is stable for 24 hours at room temperature or 7 days under refrigeration. Do not use if solution is cloudy or contains precipitate. Monitor renal function and adjust dose in patients with creatinine clearance <50 mL/min. Probenecid reduces renal excretion; avoid co-administration. Ceftazidime has activity against Pseudomonas aeruginosa; consider combination therapy for serious infections. |
| Patient Advice | This medication is given through a vein (IV) and should not be mixed with other medications in the same IV line unless instructed. · Report any signs of allergic reaction, such as rash, itching, or difficulty breathing, immediately. · Notify your healthcare provider if you have diarrhea, especially if it is watery or bloody, as this could indicate a Clostridium difficile infection. · Kidney function may be monitored during treatment; inform your doctor if you have kidney disease. · Avoid alcohol while taking this medication, as it may cause a disulfiram-like reaction. |