TAZICEF
Clinical safety rating: caution
Comprehensive clinical and safety monograph for TAZICEF (TAZICEF).
Ceftazidime is a third-generation cephalosporin that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), specifically PBP-3, leading to cell lysis and death.
| Metabolism | Ceftazidime is primarily eliminated unchanged by the kidneys via glomerular filtration; minimal hepatic metabolism. |
| Excretion | Primarily renal (80-90% unchanged via glomerular filtration and tubular secretion); biliary/fecal <10%. |
| Half-life | 2 hours (prolonged to 4-12 hours in renal impairment; anuria: 20-30 hours). |
| Protein binding | 10-17% (primarily albumin). |
| Volume of Distribution | 0.23-0.36 L/kg (indicates distribution primarily in extracellular fluid; increased in inflammation). |
| Bioavailability | IM: 90-100%. |
| Onset of Action | IM: 1-2 hours; IV: immediate (within minutes). |
| Duration of Action | 6-8 hours (dose-dependent; prolonged in renal failure). |
| Molecular Weight | 546.58 |
2 g intravenously every 8 hours for serious infections; 1 g intravenously every 8 hours for uncomplicated infections.
| Dosage form | INJECTABLE |
| Renal impairment | CrCl 31-50 mL/min: 1 g every 12 hours; CrCl 16-30 mL/min: 1 g every 24 hours; CrCl <15 mL/min: 500 mg every 24 hours; hemodialysis: 1 g after dialysis on dialysis days. |
| Liver impairment | No specific dose adjustment required for hepatic impairment; use standard dosing. |
| Pediatric use | Neonates (0-4 weeks): 30 mg/kg every 12 hours; Infants and children >1 month: 30-50 mg/kg every 8 hours; maximum 6 g/day. |
| Geriatric use | No specific dose adjustment for age; adjust dose based on renal function according to CrCl. |
| 1st trimester | Limited human data; animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity. Use only if clearly needed. |
| 2nd trimester | No evidence of teratogenicity in animal studies; human data limited. Considered safe when clinically indicated. |
| 3rd trimester | No known fetal risk; can be used for maternal infections near term. Monitor for potential effects on neonatal flora. |
Clinical note
Comprehensive clinical and safety monograph for TAZICEF (TAZICEF).
| Placental transfer | Ceftazidime crosses the placenta with fetal serum concentrations approximately 20–40% of maternal levels after usual doses. |
| Breastfeeding | Ceftazidime is excreted into breast milk in low concentrations (estimated infant dose <1% of maternal weight-adjusted dose). Not expected to cause adverse effects in nursing infants. Compatible with breastfeeding per American Academy of Pediatrics. |
■ FDA Black Box Warning
Ceftazidime is contraindicated in patients with a history of immediate hypersensitivity reaction (e.g., anaphylaxis) to ceftazidime or any other beta-lactam antibiotic.
| Serious Effects |
Hypersensitivity to ceftazidime or any cephalosporinSevere immediate hypersensitivity reaction to penicillins (cross-sensitivity)
| Precautions | Hypersensitivity reactions including anaphylaxis; cross-sensitivity with other beta-lactams., Clostridioides difficile-associated diarrhea (CDAD) may occur., Neurological adverse effects (e.g., seizures) especially in patients with renal impairment or high doses., Hemolytic anemia (immune-mediated) has been reported., Superinfection with non-susceptible organisms, including fungi., Alteration in coagulation parameters (prolonged PT/INR) in patients with renal impairment or malnourished states., Renal function monitoring required, especially in elderly and those with pre-existing renal impairment. |
| Food/Dietary | No known food interactions. Take with or without food. Avoid alcohol during treatment and for at least 48 hours after completion to prevent disulfiram-like reactions (though rare with cephalosporins). |
Loading safety data…
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Ceftazidime (TAZICEF) is classified as FDA Pregnancy Category B. Animal studies have not demonstrated fetal risk, and there are no adequate well-controlled studies in pregnant women. It should be used during pregnancy only if clearly needed. During the first trimester, theoretical risk exists but no evidence of teratogenicity. In the second and third trimesters, no known fetal adverse effects have been reported. Use is generally considered safe. |
| Fetal Monitoring | Monitor for maternal signs of hypersensitivity, superinfection, and diarrhea (Clostridioides difficile). In the fetus, no specific monitoring is required, but assess for potential changes in fetal gut flora if used near term. No dose-related ototoxicity or nephrotoxicity specific to pregnancy. |
| Fertility Effects | No evidence of impaired fertility in animal studies. Human data are lacking; no known adverse effects on fertility or reproductive capacity. |
| Clinical Pearls | TAZICEF is a brand of ceftazidime, a third-generation cephalosporin with potent anti-pseudomonal activity. It is primarily used for nosocomial infections, especially in febrile neutropenia, complicated UTIs, and respiratory infections in cystic fibrosis. Renal dose adjustment is critical; calculate CrCl and adjust for GFR <50 mL/min. Do not co-administer with vancomycin in the same IV line due to precipitation. For intra-abdominal infections, consider adding metronidazole for anaerobic coverage. Monitor for C. difficile diarrhea and hypersensitivity reactions. In neonates, use with caution due to risk of kernicterus. |
| Patient Advice | Take this medication exactly as prescribed by your healthcare provider. · Complete the full course of therapy even if you feel better. · If you miss a dose, take it as soon as you remember. If it is near time for the next dose, skip the missed dose and resume your regular schedule. · Notify your doctor immediately if you experience severe diarrhea, rash, difficulty breathing, or swelling of the face or throat. · This medication may cause dizziness; avoid driving or operating machinery if affected. |