Classifications: antibiotic; third-generation cephalosporin; Therapeutic: antibiotic; cephalosporin
Prototype: Cefotaxime sodium
Pregnancy Category: B
500 mg, 1 g, 2 g injection
Semisynthetic, third-generation broad-spectrum cephalosporin antibiotic. Preferentially binds to one or more of the penicillin-binding
proteins (PBP) located on cell walls of susceptible microbes; this inhibits third and final stage of bacterial cell wall
synthesis, leading to cell death of the bacterium.
Third-generation cephalosporins are more active and have a broader spectrum against aerobic gram-negative bacteria than
do either first- or second-generation agents.
To treat infections of lower respiratory tract, skin and skin structures, urinary tract, bones, and joints; also used to
treat bacteremia, gynecological, intra-abdominal, and CNS infections (including meningitis).
Hypersensitivity to cephalosporins and related beta-lactam antibiotics; viral disease.
Pregnancy (category B); elderly; coagulopathy, renal disease, renal impairment; GI disease; colitis.
Route & Dosage
|Moderate to Severe Infections
Adult: IV/IM 12 g q812h, up to 2 g q6h
Geriatric: IV/IM 12 g q12h
Child: IV/IM 3050 mg/kg/d q8h (max: 6 g/d)
Neonate (≤4 wk): IV 30 mg/kg q12h
Very Severe Infection
Adult: IV 2 g q8h
Clcr 3050 mL/min: dose q12h; 1030 mL/min: dose q24h; <10 mL/min: dose q4872h
Hemodialysis: Removed by dialysis
- Reconstitute by adding 3 mL sterile water or bacteriostatic water for injection or 0.5% or 1% lidocaine HCl injection
to 1 g vial to yield 280 mg/mL.
- Inject into large muscle mass (e.g., upper outer quadrant of gluteus maximus or lateral part of thigh).
PREPARE: Direct: Add 10 mL of sterile water for injection to 1 g to yield 280 mg/mL. Intermittent: Further dilute with 50100 mL of D5W, NS, or RL.
ADMINISTER: Direct: Give over 35 min. Intermittent: Give over 3060 min. If given through a Y-type set, discontinue other solutions during infusion of ceftazidime.
INCOMPATIBILITIES Solution/additive: aminoglycosides, aminophylline, ciprofloxacin, ranitidine, sodium bicarbonate. Y-site: Alatrofloxacin, amiodarone, aminoglycosides, amphotericin B cholesteryl complex, amsacrine, azithromycin, clarithromycin, doxorubicin liposome, fluconazole, idarubicin, midazolam, pentamidine, sargramostim, vancomycin, warfarin.
- Protect sterile powder from light. Reconstituted solution is stable 7 d when refrigerated at 4°5° C (39°41°
F); for 1824 h when stored at 15°30° C (59°86° F).
Adverse Effects (≥1%)Body as a Whole:
Fever, phlebitis, pain or inflammation at injection site, superinfections. GI:
Nausea, vomiting, diarrhea,
abdominal pain, metallic taste, drug-associated pseudomembranous colitis. Skin:
Pruritus, rash, urticaria. Urogenital: Vaginitis
Diagnostic Test Interference
False-positive reactions for urine glucose have been reported using copper sulfate (e.g., Benedict's solution, Clinitest). Glucose oxidase tests (Clinistix, TesTape) are unaffected. May cause positive direct antiglobulin (Coombs') test results, which can interfere with hematologic studies and transfusion cross-matching procedures.
elimination of ceftazidine.
1 h. Distribution: CNS
penetration with inflamed meninges; also penetrates bone, gallbladder, bile, endometrium, heart, skin, and ascitic and
pleural fluids; crosses placenta. Metabolism:
Not metabolized. Elimination:
8090% unchanged in urine in 24 h; small amount in breast milk. Half-Life:
Assessment & Drug Effects
- Determine history of hypersensitivity to cephalosporins and penicillins, and other drug allergies, before therapy begins.
- Lab tests: Perform culture and sensitivity studies before initiation of therapy and during therapy as indicated. Therapy
may begin pending test results.
- If administered concomitantly with another antibiotic, monitor renal function and report if symptoms of dysfunction appear
(e.g., changes in I&O ratio and pattern, dysuria).
- Be alert to onset of rash, itching, and dyspnea. Check patient's temperature. If it is elevated, suspect onset of hypersensitivity
reaction (see Appendix F).
- Monitor for superinfection. (See Appendix F.)
- If diarrhea occurs and is severe, suspect pseudomembranous colitis (caused by Clostridium difficile). Check temperature: Report fever and severe diarrhea to physician; drug should be discontinued.
Patient & Family Education
- Report loose stools or diarrhea promptly.
- Report any signs or symptoms of superinfection promptly (see Appendix F).