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Adults: The adult dosage range for ceftazidime is 1 to 6 g per day 8 or 12 hourly (i.m. or i.v.). In the majority of infections, 1 g 8-hourly or 2 g 12-hourly should be given. In urinary tract infections and in many less serious infections, 500 mg or 1 g 12-hourly is usually adequate.
In very severe infections, especially immunocompromised patients, including those with neutropenia, 2 g 8 or 12-hourly or 3 g 12-hourly should be administered. When used as a prophylactic agent in prostatic surgery, 1 g (from the 1 g vial) should be given at the induction of anaesthesia. A second dose should be considered at the time of catheter removal.
Infants and children (greater than 2 months): The usual dosage range for children aged over two months is 30 to 100 mg/kg/day, given as two or three divided doses. Doses up to 150 mg/kg/day (maximum 6 g daily) in three divided doses may be given to infected immunocompromised or fibrocystic children or children with meningitis.
Neonates and children up to 2 months of age: Whilst clinical experience is limited, a dose of 25 to 60 mg/kg/day given as two divided doses has proved to be effective. In the neonate the serum half-life of ceftazidime can be three to four times that in adults. Elderly
In view of the reduced clearance of ceftazidime in acutely ill elderly patients, the daily dosage should not normally exceed 3 g, especially in those over 80 years of age.
Renal impairment: Ceftazidime is excreted unchanged by the kidneys. Therefore, in patients with impaired renal function it is recommended that the dosage of ceftazidime should be reduced to compensate for its slower excretion, except in mild impairment, i.e. glomerular filtration rate (GFR) greater than 50 ml/min. In patients with suspected renal insufficiency, an initial loading dose of 1 g of ceftazidime may be given. An estimate of GFR should be made to determine the appropriate maintenance dose.
Severe infections including infections due to pseudomonas. Hospital only.
Known hypersensitivity to cephalosporins.
Symptoms of pseudomembranous colitis may occur during or after antibiotic treatment. Mild cases of pseudomembranous colitis usually respond to drug discontinuation alone. Use during pregnancy only if clearly needed. Caution should be exercised when administered to nursing mothers. Safety and effectiveness in infants under 6 months of age have not been established.
Headache, dizziness, GI disturbances, genital pruritus, vaginitis, candidiasis.
Concurrent use of high doses with nephrotoxic drugs may adversely affect renal function.
Chloramphenicol is antagonistic in vitro with ceftazidime and other cephalosporins. The clinical relevance of this finding is unknown, but if concurrent administration of ceftazidime with chloramphenicol is proposed, the possibility of antagonism should be considered.
In common with other antibiotics, ceftazidime may affect the gut flora, leading to lower oestrogen reabsorption and reduced efficacy of combined oral contraceptives. Ceftazidime does not interfere with enzyme-based tests for glycosuria. Slight interference with copper reduction methods (Benedict’s, Fehling’s, Clinitest). Ceftazidime does not interfere in the alkaline picrate assay for creatinine.
Pregnancy and Lactation
Pregnancy: There is no experimental evidence of embryopathic or teratogenic effects attributable to ceftazidime but, as with all drugs, it should be administered with caution during the early months of pregnancy and in early infancy.
Lactation: Ceftazidime is excreted in human milk in low concentrations and consequently caution should be exercised when ceftazidime is administered to a nursing mother.
Symptoms and Signs: Overdose can lead to neurological sequelae including encephalopathy, convulsions and coma.
Treatment: Serum levels of ceftazidime can be reduced by haemodialysis or peritoneal dialysis