Generic drug: ceftazidime
Brand name: Tazicef
What is Tazicef (ceftazidime), and how does it work?
Tazicef (ceftazidime) is a broad-spectrum antibiotic indicated for the treatment of patients with infections (lower respiratory tract infections, skin infections, urinary tract infections, bacterial septicemia, bone and joint infections, gynecologic infections, intra-abdominal infections, and central nervous system infections) caused by susceptible strains of the designated organisms.
What are the side effects of Tazicef?
Common side effects of Tazicef include:
- injection site inflammation
- abdominal pain
- numbness and tingling
- vaginal yeast infection, and
- oral thrush
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Tazicef (ceftazidime) and other antibacterial drugs, Tazicef (ceftazidime) should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.
What is the dosage for Tazicef?
The usual adult dosage is 1 gram administered intravenously every 8 to 12 hours. The dosage and route should be determined by the susceptibility of the causative organisms, the severity of infection, and the condition and renal function of the patient.
The guidelines for dosage of Tazicef (ceftazidime for injection, USP) are listed in Table 3. The following dosage schedule is recommended.
Table 3: Recommended Dosage Schedule
|Usual recommended dosage||1 gram intravenous||every 8 to 12 hours|
|Uncomplicated urinary tract infection||250 mg intravenous||every 12 hours|
|Bone and joint infections||2 grams intravenous||every 12 hours|
|Complicated urinary tract infections||500 mg intravenous||every 8 to12 hours|
|Uncomplicated pneumonia; mild skin and skin- structure infections||500 mg to 1 gram intravenous||every 8 hours|
|Serious gynecological and intra-abdominal infections||2 grams intravenous||every 8 hours|
|Meningitis||2 grams intravenous||every 8 hours|
|Very severe life-threatening infections, especially in immunocompromised patients||2 grams intravenous||every 8 hours|
|Lung infections caused by Pseudomonas spp. in patients with cystic fibrosis with normal renal function*||30 to 50 mg/kg intravenous to a maximum of 6 grams per day||every 8 hours|
|Neonates (0-4 weeks)||30 mg/kg intravenous||every 12 hours|
|Infants and children (1 month-12 years)||30 to 50 mg/kg intravenous to a maximum of 6 grams per day†||every 8 hours|
|* Although clinical improvement has been shown, bacteriologic cures cannot be expected in patients with chronic respiratory disease and cystic fibrosis.|
†The higher dose should be reserved for immunocompromised pediatric patients or pediatric patients with cystic fibrosis or meningitis.
Impaired Hepatic Function
No adjustment in dosage is required for patients with hepatic dysfunction.
Impaired Renal Function
Ceftazidime is excreted by the kidneys, almost exclusively by glomerular filtration. Therefore, in patients with impaired renal function (glomerular filtration rate [GFR] <50 mL/min), it is recommended that the dosage of ceftazidime be reduced to compensate for its slower excretion. In patients with suspected renal insufficiency, an initial loading dose of 1 gram of ceftazidime may be given. An estimate of GFR should be made to determine the appropriate maintenance dosage. The recommended dosage is presented in Table 4.
Table 4: Recommended Maintenance Dosages of Tazicef (ceftazidime for injection, USP) in Renal Insufficiency
|Creatinine Clearance (mL/min)||Recommended Unit Dose of Tazicef||Frequency of Dosing|
|50 to 31||1 gram||every 12 hours|
|30 to 16||1 gram||every 24 hours|
|15 to 6||500 mg||every 24 hours|
|less than 5||500 mg||every 48 hours|
When only serum creatinine is available, the following formula (Cockcroft's equation)1 may be used to estimate creatinine clearance. The serum creatinine should represent a steady state of renal function:
Males: Creatinine clearance (mL/min) = Weight (kg) x (140 - age) /72 x serum creatinine (mg/dL)
Females: 0.85 x male value
In patients with severe infections who would normally receive 6 grams of Tazicef daily were it not for renal insufficiency, the unit dose given in the table above may be increased by 50% or the dosing frequency may be increased appropriately. Further dosing should be determined by therapeutic monitoring, severity of the infection, and susceptibility of the causative organism.
In pediatric patients as for adults, the creatinine clearance should be adjusted for body surface area or lean body mass, and the dosing frequency should be reduced in cases of renal insufficiency.
In patients undergoing hemodialysis, a loading dose of 1 gram is recommended, followed by 1 gram after each hemodialysis period.
Tazicef (ceftazidime for injection, USP) can also be used in patients undergoing intraperitoneal dialysis and continuous ambulatory peritoneal dialysis. In such patients, a loading dose of 1 gram of Tazicef may be given, followed by 500 mg every 24 hours. In addition to IV use, Tazicef can be incorporated in the dialysis fluid at a concentration of 250 mg for 2 L of dialysis fluid.
Note: Generally, Tazicef should be continued for 2 days after the signs and symptoms of infection have disappeared, but in complicated infections longer therapy may be required.
What drugs interact with Tazicef?
- Nephrotoxicity has been reported following concomitant administration of cephalosporins with aminoglycoside antibacterial drugs or potent diuretics such as furosemide.
- Renal function should be carefully monitored, especially if higher dosages of the aminoglycosides are to be administered or if therapy is prolonged, because of the potential nephrotoxicity and ototoxicity of aminoglycoside antibacterial drugs. Nephrotoxicity and ototoxicity were not noted when ceftazidime was given alone in clinical trials.
- Chloramphenicol has been shown to be antagonistic to beta-lactam antibacterial drugs, including ceftazidime, based on in vitro studies and time kill curves with enteric gram-negative bacilli. Due to the possibility of antagonism in vivo, particularly when bactericidal activity is desired, this drug combination should be avoided.
- In common with other antibacterial drugs, ceftazidime may affect the gut flora, leading to lower estrogen reabsorption and reduced efficacy of combined oral estrogen/progesterone contraceptives.
Is Tazicef safe to use while pregnant or breastfeeding?
- Pregnancy Category B. Reproduction studies have been performed in mice and rats at doses up to 40 times the human dose and have revealed no evidence of impaired fertility or harm to the fetus due to Tazicef.
- There are, however, no adequate and wellcontrolled studies in pregnant women.
- Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
- Ceftazidime is excreted in human milk in low concentrations. Caution should be exercised when Tazicef is administered to a nursing woman.
Tazicef (ceftazidime) is a broad-spectrum antibiotic indicated for the treatment of patients with infections (lower respiratory tract infections, skin infections, urinary tract infections, bacterial septicemia, bone and joint infections, gynecologic infections, intra-abdominal infections, and central nervous system infections) caused by susceptible strains of the designated organisms. Common side effects of Tazicef include injection site inflammation, itching, rash, fever, diarrhea, nausea, vomiting, abdominal pain, headache, dizziness, numbness and tingling, vaginal yeast infection, and oral thrush.
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