Cephalosporins類抗生素 (三四代)

Bloodstream infection (gram-negative bacteremia): caused by P. aeruginosa, Klebsiella spp., H. influenzae, E. coli, Serratia spp., S. pneumoniae, and S. aureus
Bone and joint infections: caused by P. aeruginosa, Klebsiella spp., Enterobacter spp., and S. aureus
CNS infections: caused by H. influenzae and Neisseria meningitidis; also been used in cases of meningitis due to P. aeruginosa and S. pneumoniae
Empiric therapy in immunocompromised patients: Empiric treatment of infections in immunocompromised patients
Gynecologic infections: Treatment of endometritis, pelvic cellulitis, and other infections of the female genital tract caused by E. coli
Intra-abdominal infection, health care-associated or high-risk community-acquired infection: caused by E. coli, Klebsiella spp., S. aureus
Lower respiratory tract infections: including pneumonia; caused by P. aeruginosa, H. influenzae, Enterobacter spp., Proteus mirabilis. E. coli. Serratia spp., Citrobacter spp., S. pneumoniae, and S. aureus
Skin and soft tissue infections: caused by P. aeruginosa, Klebsiella spp., E. coli, Proteus spp., Enterobacter spp., Serratia spp., S. aureus, and Streptococcus pyogenes
Urinary tract infection: caused by P. aeruginosa, Enterobacter spp., Proteus spp., Klebsiella spp., and E. coli

Antibiotic, Cephalosporin (Third Generation)
Ceftazidime is a semisynthetic, broad-spectrum, beta-lactam antibiotic which inhibits enzymes responsible for cell-wall synthesis. It is bactericidal against a wide range of gram-negative and gram-positive organisms but is highly stable to clinically important plasmid and chromosomal beta-lactamases produced by these organisms.

Widely distributed throughout the body including bone, bile, skin, CSF (higher concentrations achieved when meninges are inflamed), endometrium, heart, pleural and lymphatic fluids; approximately 80% to 90% unchanged excreted in urine over a 24-hour period. Dialyzable: yes (hemodialysis); yes (peritoneal dialysis).

Patients with known hypersensitivity to cephalosporins.

B

Enters breast milk/ use caution

Eosinophilia, positive direct Coombs test, thrombocythemia; Increased serum ALT and AST, increased serum alkaline phosphatase ; Increased lactate dehydrogenase, increased gamma-glutamyl transferase; Allergic reaction; Phlebitis

Usual dosage:
1. Traditional intermittent infusion method:
(IV) 1-2g Q8H infused over 30 minutes; for treatment of very severe life-threatening infections, 2g Q8H
2. Extended infusion method (off-label method):
(IV) 2 g Q8H infused over 3 to 4 hours; may give first dose over 30 minutes, especially when rapid attainment of therapeutic drug concentrations is desired (eg, sepsis)
3. Continuous infusion method (off-label method):
(IV) 6 g infused over 24 hours; may give first dose of 2 g over 30 minutes, especially when rapid attainment of therapeutic drug concentrations is desired (eg, sepsis)

General dosing, susceptible infection: IM, IV
1. Non-Pseudomonas spp. infections: 90-150 mg/kg/day divided every 8 hours; maximum 6 g/day
2. Pseudomonas spp. infections:
(1) Mild to moderate infections: 90-150 mg/kg/day divided Q8H; maximum 6 g/day
(2) Severe infections: 200-300 mg/kg/day divided Q8H; maximum 12 g/day

If the usual recommended dose is 1g Q8H:
1. CrCl >50 mL/min: No dose adjustment necessary
2. CrCl 31-50 mL/min: 1g Q12H
3. CrCl 16-30 mL/min: 1g Q24H
4. CrCl ≤15 mL/min: 500mg Q24H
If the usual recommended dose is 2g Q8H:
1. CrCl >50 mL/min: No dose adjustment necessary
2. CrCl 31-50 mL/min: 2g Q12H
3. CrCl 16-30 mL/min: 2g Q24H
4. CrCl ≤15 mL/min: 1g Q24H
Hemodialysis, intermittent (thrice weekly):
Dialyzable (55% to 88% utilizing low-flux filters)
(IV) 500 mg to 1 g every 24 hours; administer after hemodialysis on dialysis days