CEFTIZOXIME SODIUM
| CEFTIZOXIME SODIUM (sef-ti-zox'eem) Cefizox Classifications: antibiotic; third-generation cephalosporin; Therapeutic:antibiotic; cephalosporin Prototype: Cefotaxime sodium Pregnancy Category: B |
Availability
1 g, 2 g injection
Action
Semisynthetic third-generation cephalosporin antibiotic. Preferentially binds to one or more of the penicillin-binding proteins (PBP) located on cell walls of susceptible organisms. This inhibits third and final stage of bacterial cell wall synthesis, thus killing the bacterium.
Therapeutic Effect
Generally resistant to inactivation by beta-lactamases that act principally as cephalosporinases and penicillinases. Its spectrum includes some gram-positive organisms but has predominantly gram-negative coverage.
Uses
Infections caused by susceptible organisms in lower respiratory tract, skin and skin structures, urinary tract, bones and joints; also used to treat intra-abdominal infections, pelvic inflammatory disease, uncomplicated gonorrhea, meningitis (Haemophilus influenzae, Streptococcus pneumoniae), and for surgical prophylaxis.
Unlabeled Uses
Meningitis caused by Neisseria meningitidis and E. coli.
Contraindications
Hypersensitivity to cephalosporins and other beta-lactam antibiotics; viral disease. Safe use in infants <6 mo not established.
Cautious Use
Penicillin hypersensitivity; coagulopathy; GI disease, colitis; elderly; renal disease, renal impairment; lactation; pregnancy (category B).
Route & Dosage
| Moderate to Severe Infections Adult: IV/IM 1–2 g q8–12h, up to 2 g q4h Child (≥6 mo): IV/IM 50 mg/kg q6–8h, up to 200 mg/kg/d Life Threatening Infections Adult: IV 3–4 g q8h Renal Impairment Use lower dose. Dialysis: Administer dose after dialysis |
Administration
Intramuscular- Reconstitute as follows with sterile water for injection: add 1.5 mL to 500 mg to yield 280 mg/mL; add 3 mL to 1 g or 6 mL to 2 g to yield 270 mg/mL.
- Give deep IM into a large muscle. Give no more than 1 g into a single injection site.
| Intravenous PREPARE: Direct: Reconstitute each 1 g with 10 mL sterile water. Shake well. Intermittent: Further dilute in 50–100 mL D5W, NS, D5/NS, D5/.45% NaCl, RL, or other compatible IV solution. ADMINISTER: Direct: Give over 3–5 min. Intermittent: Give over 30 min. INCOMPATIBILITIES Solution/additive: Promethazine. Y-site: Filgrastim, lansoprazole, vancomycin. |
- Protect from light. Consult manufacturer's directions concerning storage of reconstituted solutions.
Adverse Effects (≥1%)
Body as a Whole: Fever, phlebitis, vaginitis, pain and induration at injection site, paresthesia. GI: Nausea, vomiting, diarrhea, pseudomembranous colitis. Skin: Rash, pruritus.Diagnostic Test Interference
Ceftizoxime causes false-positive direct Coombs' test (may interfere with cross-matching procedures and hematologic studies).
Interactions
Drug: Probenecid decreases renal elimination of ceftizoxime.Pharmacokinetics
Peak: 1 h. Distribution: Crosses placenta. Metabolism: Not metabolized. Elimination: 80–90% unchanged in urine in 24 h; small amount in breast milk. Half-Life: 25–60 min.Nursing Implications
Assessment & Drug Effects
- Determine history of hypersensitivity reactions to cephalosporins, penicillin, or other drugs before therapy is instituted. Report to physician history of allergy, particularly to drugs.
- Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy if indicated. Therapy may be instituted pending test results.
- Be alert to symptoms of hypersensitivity reaction (see Appendix F). Serious reactions may require emergency measures.
Patient & Family Education
- Report loose stools or diarrhea promptly.
- Report any signs or symptoms of hypersensitivity (see Appendix F) promptly.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug