Ceftazidime Pentahydrate

Indications
Ceftazidime is indicated for Single infections, Mixed infections, Severe infections in general, Respiratory tract infections, Ear, nose and throat infections, Skin and soft tissue infections, Gastrointestinal, biliary and abdominal infections, Bone and joint infections, Dialysis: Infections associated with hemo and peritoneal dialysis and with continuous ambulatory peritoneal dialysis (CAPD).

Therapeutic Class
Third generation Cephalosporins

Pharmacology
Ceftazidime binds to 1 or more of the penicillin-binding proteins (PBPs) which inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

Dosage & Administration
Prophylaxis of surgical infection in patients undergoing prostate surgery:
Adult: 1 g at induction of anaesth repeated if necessary upon removal of catheter. It is given as deep IM inj, slow IV inj over 3-5 min or IV infusion for up to 30 min.
Elderly: >80 yr Max: 3 g daily.
Pseudomonal lung infections in cystic fibrosis:
Adult: 100-150 mg/kg 8 hrly as deep IM inj, slow IV inj over 3-5 min or IV infusion for up to 30 min. Max: 9 g daily.
Child: Elderly: >80 yr Max: 3 g daily
Bone and joint infections, Complicated intra-abdominal infections, Skin and skin structure infections, complicated:
Adult: 1-2 g 8 hrly as deep IM inj, slow IV inj over 3-5 min or IV infusion for up to 30 min.
Child: Elderly: >80 yr Max: 3 g daily.
Bacterial meningitis, Empiric therapy for febrile neutropenic patients, Nosocomial pneumonia:
Adult: 2 g 8 hrly as deep IM inj, slow IV inj over 3-5 min or IV infusion for up to 30 min.
Child: Elderly: >80 yr Max: 3 g daily.
Complicated urinary tract infections:
Adult: 1-2 g 8-12 hrly as deep IM inj, slow IV inj over 3-5 min or IV infusion for up to 30 min.
Child: Elderly: >80 yr Max: 3 g daily.

Interaction
Increased nephrotoxicity has been reported following concomitant administration of Cephalosporins and aminoglycoside antibiotics.

Contraindications
Ceftazidime is contraindicated in patients with known hypersensitivity to cephalosporin antibiotics.

Side Effects
The most common side-effects are local reactions following IV injection and allergic and gastrointestinal reactions. Hypersensitivity reactions are pruritus, rash, and fever. Angioedema and anaphylaxis have been reported very rarely. Gastrointestinal symptoms are diarrhea, nausea, vomiting, and abdominal pain. Central nervous system reactions included headache, dizziness, and paresthesia.

Pregnancy & Lactation
Pregnancy: No adequate and well controlled studies in pregnant women have been conducted with Ceftazidime. Because animal reproduction studies are not always predictive of human response this drug should be used during pregnancy only if clearly needed.
Lactation: Ceftazidime is excreted in human milk in low concentrations. Because many drugs are excreted in human milk and because safety of the component of the injections in nursing infants has not been established, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Precautions & Warnings
The total daily dosage should be reduced when Ceftazidime is administered to patients with renal insufficiency. Ceftazidime should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.

Overdose Effects
Symptoms: Seizure activity, encephalopathy, asterixis, neuromuscular excitability, coma.
Management: Symptomatic and supportive treatment. In the presence of renal insufficiency, haemodialysis or peritoneal dialysis may aid in the removal of the drug from the body.

Reconstitution
Single-dose vial Administration Amount of WFI to be added:
250 mg IM in 1.5 ml
250 mg IV in 5 ml
500 mg IM in 1.5 ml
500 mg IV in 5 ml
1 gm IM in 3 ml
1 gm IV in 10 ml
Step 1: Add recommended volume of solvent slowly. Remove the syringe needle.
Step 2: Gently shake the vial to dissolve the powder. Carbon dioxide is released & a clear solution will be obtained.
Step 3: Now insert the needle in the free space of the reconstituted vial & withdraw the pressurized air from the free space.
Step 4: Finally withdraw the solution from the vial by syringe

Storage Conditions
Store below 25° C, protected from light and moisture. Reconstituted solutions are stable for up to 24 h if stored between 2°-8° C