Pharmacy No. 84. Delivery of medicines to your home and office.

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Instructions for use CEFTAZIDIME

There have been no reports of severe, life-threatening hypersensitivity reactions during treatment with Ceftazidime. However, if a severe hypersensitivity reaction develops when using Ceftazidime, its administration should be stopped immediately and adequate assistance measures should be taken (administration of β-adrenergic agonists and glucocorticosteroids). Before starting therapy with Ceftazidime, it is recommended to clarify the patient’s allergy history regarding Ceftazidime and other cephalosporins. In patients with mild hypersensitivity reactions to β-lactams, ceftazidime should be administered with extreme caution.

Ceftazidime has a limited spectrum of antimicrobial activity. It should not be used as monotherapy in the treatment of infections if the patient has not identified a pathogen sensitive to Ceftazidime or is not completely sure that the infection is caused by such a pathogen. This warning is especially important when treating patients with bacteremia, bacterial meningitis, skin and soft tissue infections, and bone and joint infections. Ceftazidime is hydrolyzed by extended-spectrum β-lactamases (ESBLs), so the clinician should consider the prevalence of ESBL strains of microorganisms in the region.

There are reports of the development of antibiotic-associated colitis or pseudomembranous colitis from mild to severe (life-threatening) degrees after the use of antibacterial agents (including ceftazidime). The likelihood of developing this complication should be carefully assessed when treating patients with ceftazidime who develop diarrhea during or after treatment with ceftazidime. If this complication develops, Ceftazidime therapy should be discontinued and specific therapy for Clostridium difficile infection should be started. The use of drugs that suppress peristalsis (loperamide, butylscopolamine, atropine, etc.) in such patients is not allowed.

Simultaneous administration of high doses of cephalosporins and nephrotoxic drugs (aminoglycosides, loop diuretics - furosemide) can cause deterioration of renal function.

Ceftazidime is eliminated through the kidneys, so its dose should be adjusted if renal function worsens. In patients with renal failure, the effectiveness and safety of therapy should be carefully monitored. There are isolated reports of the development of neurological complications when using unadjusted doses of ceftazidime in patients with impaired renal function.

Long-term use of Ceftazidime may lead to the growth of insensitive flora (enterococci, fungi), which may require discontinuation of therapy or other measures. Such patients should be re-evaluated.

Ceftazidime does not change the results of enzymatic tests for assessing glycosuria in patients with diabetes mellitus, but may change the results (false-positive reactions) of tests based on the use of the copper reduction reaction (Benedict, Fehling, Clinitest). Ceftazidime does not interact with reagents (alkaline picrate reagent) for assessing creatinine levels. In 5% of patients using Ceftazidime, a false-positive Coombs test may occur.

Important information regarding excipients:

1 g of Ceftazidime contains 2.26 mmol sodium. This information should be taken into account when treating patients in whom the amount of salt in the diet is controlled.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

No studies have been conducted on the effect on the ability to drive a car or operate machinery. However, undesirable effects (for example, dizziness) may occur that affect the ability to drive and operate machines.

Ceftazidim

The drug Ceftazidime is used only parenterally. The dose of the drug is set individually, taking into account the severity of the disease, the location of the infection and the sensitivity of the pathogen, age and body weight, and renal function.

After diluting the contents of the bottle, the drug is administered intramuscularly (should be injected into large muscles) or intravenously (stream or drip), 500 mg - 2 g every 8 - 12 hours. For most infections, a dose of 1 g every 8 hours or 2 hours is effective. g every 12 hours. In immunocompromised patients, including patients with neutropenia and severe disease, Ceftazidime should be prescribed 2 g every 8 or 12 hours.

Adults and teenagers

Complicated urinary tract infections

- IM or IV 0.5-1 g every 8-12 hours.

Uncomplicated pneumonia and skin infections

- IM or IV 0.5-1 g every 8 hours.

Cystic fibrosis, lung infections caused by Pseudomonas spp

. - from 100 to 150 mg / kg /, frequency of administration - 3 times / day (use of a dose of up to 9 g / in such patients did not cause complications).

Bone and joint infections -

IV 2 g every 12 hours.

For extremely severe or life-threatening infections

- IV 2 g every 8 hours.

After an initial loading dose of 1 g in adults with renal impairment (including patients undergoing dialysis)

Dose reduction may be necessary as follows:

Creatinine clearance	Dose
> 50 ml/min (0.83 ml/sec)	usual doses for adults and adolescents
35-50 ml/min (0.52-0.83 ml/sec)	1 g every 12 hours
16-30 ml/min (0.27-0.50 ml/sec)	1 g every 24 hours
6-15 ml/min (0.10-0.25 ml/sec)	500 mg every 24 hours
< 5 ml/min (0.08 ml/sec)	500 mg every 48 hours
Patients undergoing hemodialysis	1 g after each hemodialysis session
Patients undergoing peritoneal dialysis	500 mg every 24 hours

These figures are indicative. In such patients, it is recommended to monitor serum drug levels, which should not exceed 40 mg/l.

T1/2 of the drug during hemodialysis is 3-5 hours. The appropriate dose of the drug should be repeated after each dialysis period.

With peritoneal dialysis

Ceftazidime can be included in the dialysis fluid at a dose of 125 mg to 250 mg per 2 liters of dialysis fluid.

Children

Children under 1 month of age

Side effects of the drug Ceftazidime

phlebitis at the site of intravenous injection (less than 2% of cases), allergic reactions (less than 2% of cases) - skin rash, itching, fever, extremely rarely - Quincke's edema, bronchospasm, arterial hypotension; disorders of the digestive tract (less than 2% of cases) - diarrhea, nausea, vomiting and abdominal pain, symptoms of pseudomembranous colitis, which may appear during or after completion of treatment; disorders of the central nervous system (less than 1% of cases) - headache, dizziness and paresthesia, epileptic seizures; the development of candidiasis (including candidal stomatitis and vaginitis) is possible. Laboratory tests revealed the appearance of eosinophilia, a positive Coombs test, thrombocytosis and a slight increase in the level of liver enzymes (ALAT, AST, LDH and alkaline phosphatase); rarely - transient leukopenia, neutropenia, agranulocytosis, thrombocytopenia and lymphocytosis.

Drug interactions Ceftazidime

Solutions of ceftazidime, like most β-lactam antibiotics, should not be added to solutions of aminoglycosides due to the possibility of their interaction; if simultaneous antibiotic treatment is necessary, the injection site should be changed. A nephrotoxic effect is observed after simultaneous administration of cephalosporins with aminoglycosides or with powerful diuretics (furosemide). The potential nephrotoxicity and ototoxicity of aminoglycosides should be considered, especially when administered in high doses or prolonged treatment.

Pharmacological properties of the drug Ceftazidime

Semi-synthetic β-lactam antibiotic from the group of third generation cephalosporins. It has a wide spectrum of action and is intended for parenteral use. It acts bactericidal, inhibiting the activity of microbial enzymes responsible for the synthesis of bacterial cell membranes. Resistant to β-lactamases. Ceftazidime is active both in vitro and in vivo against the following microorganisms: - gram-negative, including Pseudomonas spp . (including Pseudomonas aeruginosa ), Klebsiella spp . (including Klebsiella pneumoniae ), Proteus mirabilis, Proteus vulgaris, Escherichia coli, Enterobacter spp. (including Enterobacter cloacae and Enterobacter aerogenes ), Citrobacter spp . (including Citrobacter freundii and Citrobacter diversus ), Serratia spp., Haemophilus influenzae (including ampicillin-resistant strains) and Neisseria meningitidis ; - gram-positive, including Staphylococcus aureus, Streptococcus pyogenes A β-hemolytic streptococci ), Streptococcus agalactiae B streptococci ) and Streptococcus pneumoniae ; — anaerobic, including Bacteroides spp . (most strains of Bacteroides fragilis are resistant). The rate of elimination of ceftazidime is directly proportional to the administered dose. With intravenous administration, the half-life is about 1.9 hours, with intramuscular administration - about 2 hours. Less than 10% of ceftazidime binds to plasma proteins; this value does not depend on the concentration of the antibiotic. Not metabolized in the body, excreted mainly by the kidneys (80–90%) unchanged within 24 hours. Easily penetrates into organs and tissues of the body (including bone tissue), sputum, synovial, pleural, peritoneal fluids, tissues and eye fluid, through the placental barrier, poorly - through the intact BBB.

Ceftazidime overdose, symptoms and treatment

Manifested by pain, inflammation and phlebitis at the injection site. A significant overdose of cephalosporins can cause dizziness, paresthesia and headache. As a result of an overdose of some cephalosporins, epileptic seizures may occur, especially in patients with kidney pathology, which increases the likelihood of antibiotic accumulation. There may be an increase in the concentration of creatinine in the blood, urea, liver enzymes and bilirubin, as well as a positive Coombs test, thrombocytosis, thrombocytopenia, eosinophilia, leukopenia and an increase in prothrombin time. Treatment - in case of epileptic seizures, the antibiotic should be immediately discontinued and, if indicated, anticonvulsants should be prescribed. It is necessary to ensure monitoring of indicators of water-electrolyte and gas exchange; according to indications, carry out measures aimed at maintaining the ventilation-perfusion ratio. In cases of severe overdose, especially in patients with renal failure and when conservative therapy is ineffective, hemodialysis in combination with hemoperfusion is possible, but there is no data on the effectiveness of such therapy.

List of pharmacies where you can buy Ceftazidime:

Moscow
Saint Petersburg

Dose	Volume of solvent for intramuscular administration	Volume of solvent for intravenous administration
250 mg	1.5 ml water for injection, 1% lidocaine hydrochloride solution (without epinephrine).	5 ml water for injection
500 mg	1.5 ml water for injection	5 ml water for injection
1 g	3 ml water for injection	10 ml water for injection
2 g	3 ml water for injection	10 ml water for injection