TAZIDIME IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for TAZIDIME IN PLASTIC CONTAINER (TAZIDIME IN PLASTIC CONTAINER).
Ceftazidime inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), primarily PBP-3, leading to cell lysis and death. It is a beta-lactam antibiotic with activity against Gram-negative bacteria including Pseudomonas aeruginosa.
| Metabolism | Ceftazidime is not metabolized significantly; it is excreted unchanged primarily by the kidneys via glomerular filtration. Minimal hepatic metabolism. |
| Excretion | Primarily renal (80-90% unchanged via glomerular filtration and tubular secretion); biliary/fecal excretion accounts for <1%. |
| Half-life | Terminal elimination half-life 1.7-2.0 hours in adults with normal renal function; prolonged to 12-30 hours in end-stage renal disease. |
| Protein binding | Approximately 17% bound to plasma proteins (mainly albumin). |
| Volume of Distribution | 0.22-0.35 L/kg, indicating distribution primarily into extracellular fluid. |
| Bioavailability | IM: approximately 100% after intramuscular administration; IV: 100% (not applicable for oral absorption as ceftazidime is not available orally). |
| Onset of Action | IV: rapid, within 1-2 hours; IM: 2-4 hours. |
| Duration of Action | 6-8 hours in normal renal function; extended to 24-48 hours in severe renal impairment due to reduced clearance. |
1-2 g intravenously every 8 hours for most infections; up to 2 g every 6 hours for severe infections, particularly in neutropenic patients or those with cystic fibrosis.
| Dosage form | INJECTABLE |
| Renal impairment | CrCl >50 mL/min: no adjustment. 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. For hemodialysis: administer 1 g after each dialysis session, then every 48 hours. |
| Liver impairment | No dose adjustment required for hepatic impairment alone, as primarily renally eliminated. |
| 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, maximum 6 g/day. For severe infections (e.g., meningitis, cystic fibrosis): up to 50 mg/kg every 8 hours, maximum 6 g/day. For febrile neutropenia: 50 mg/kg every 8 hours. Administered intravenously. |
| Geriatric use | Dose based on renal function; monitor CrCl and adjust accordingly. Elderly patients often have reduced creatinine clearance; use ideal body weight for dosing. Consider lower initial doses if renal impairment present. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for TAZIDIME IN PLASTIC CONTAINER (TAZIDIME IN PLASTIC CONTAINER).
| Breastfeeding | Excreted in breast milk in low amounts; M/P ratio ~0.1. Considered compatible with breastfeeding. |
| Teratogenic Risk | Insufficient human data; animal studies show no teratogenicity. Avoid first trimester unless essential. |
| Fetal Monitoring | Monitor for hypersensitivity reactions, renal function, and signs of superinfection. |
■ FDA Black Box Warning
No FDA black box warning.
| Serious Effects |
["Hypersensitivity to ceftazidime or any cephalosporin antibiotic.","Hypersensitivity to beta-lactam antibiotics (penicillins, carbapenems, monobactams) due to cross-sensitivity."]
| Precautions | ["Hypersensitivity reactions including anaphylaxis.","Clostridium difficile-associated diarrhea (CDAD).","Neurological toxicity (seizures, encephalopathy) in patients with renal impairment or high doses.","Prolonged use may cause overgrowth of nonsusceptible organisms.","Dose adjustment required in renal impairment.","Interference with glucose testing (false-positive urinary glucose)."] |
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| Fertility Effects | No known adverse effects on fertility. |