Ceftazidime

When ATH:
J01DD02

Characteristic.

Cephalosporin antibiotic III generation for parenteral use. Powder from white to yellowish. The water forms a solution from light yellow to amber color with pH 5,0-8,0. Molecular weight 636,65.

Pharmacological action.
Broad-spectrum antibacterial, bactericide.

Application.

Infectious diseases of the respiratory tract (bronchitis, infected bronchiectasis, pneumonia, lung abscess, empyema), infections in patients with cystic fibrosis; ENT infections (incl. otitis media, malignant inflammation of the outer ear, mastoiditis, sinusitis), skin and soft tissue (flegmona, mug, wound infection, mastitis, skin ulcer), urinary tract (pyelonephritis, pyelitis, cystitis, uretrit, kidney abscess, infection, associated with bladder stones and renal), pelvic (incl. prostatitis), bone and joints (osteomyelitis, septicheskiy arthritis), GI infections, biliary tract and the abdominal cavity (kholangit, cholecystitis, gallbladder empyema, retroperitoneal abscesses, peritonitis), CNS, sepsis, meningitis, infection, associated with dialysis; gonorrhea, especially in case of hypersensitivity to the antibiotics penicillin. Infection, caused Pseudomonas aeruginosa.

Contraindications.

Hypersensitivity, incl. to other cephalosporins.

Restrictions apply.

Renal failure, colitis (history), pregnancy (I trimester), lactation, the neonatal period.

Pregnancy and breast-feeding.

When pregnancy (especially in the first months) It is possible only in those cases, the potential benefit to the mother outweighs the risk to the fetus.

Category actions result in FDA - B. (The study of reproduction in animals revealed no risk of adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not done.)

When breastfeeding used with caution (It passes into breast milk).

Side effects.

From the nervous system and sensory organs: headache, dizziness, epileptiform seizures, encephalopathy, paraesthesia, "Fluttering" tremor.

Cardio-vascular system and blood (hematopoiesis, hemostasis): leukopenia, neutropenia, agranulocytosis, thrombocytopenia, Lymphocytosis, gemoliticheskaya anemia, increased prothrombin time, gemorragii.

From the digestive tract: nausea, vomiting, diarrhea, epigastric pain, psevdomembranoznыy colitis, increase in the activity of enzymes in blood (IS, GOLD, Alkaline phosphatase, LDH), giperʙiliruʙinemija, cholestasis.

With the genitourinary system: impairment of renal function, toksicheskaya nephropathy.

Allergic reactions: skin rashes, fever, eozinofilija, itch, toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome, erythema multiforme, angioedema, bronchospasm, anaphylactic shock.

Other: kandidamikoz, giperkreatininemiя, increasing concentrations of urea, false positive reaction to urinary glucose, false-positive direct Coombs' test; reactions at the injection is soreness, burning, образование инфильтратов и абсцессов (when i / m administration), phlebitis and thrombophlebitis (at / in the introduction).

Cooperation.

Bacteriostatic antibiotics (incl. chloramphenicol) reduce the effect of ceftazidime. Ceftazidime increases nephrotoxicity of aminoglycoside antibiotics and furosemide. Loop diuretics, aminoglikozidy, vancomycin, clindamycin reduced clearance, resulting in increased risk of nephrotoxicity. Simultaneous administration of high doses of ceftazidime and nephrotoxic drugs may adversely affect renal function.

Ceftazidime is compatible with most solutions on / in the, but less stable in a solution of sodium bicarbonate, so it is not recommended for use as a solvent.

Pharmaceutical incompatible with aminoglycosides, geparinom, vancomycin, chloramphenicol. Do not interact with probenecid.

When added to a solution of vancomycin ceftazidime observed precipitation, so it is advisable to wash the infusion system between administrations of the two drugs.

Overdose.

Symptoms: headache, dizziness, paresthesia, в тяжелых случаях — генерализованные судороги.

Treatment: maintaining vital functions, при развитии судорог — антиконвульсанты, у больных с поражением почек — перитонеальный диализ или гемодиализ.

Dosing and Administration.

/ M, I / (bolus slowly over 5 minutes or infusion over 30-60 m). Adults: обычно по 1–2 г каждые 8 or h 2 g every 12 no; в тяжелых случаях — 6 g / day. При нетяжелых инфекциях и инфекциях мочевыводящих путей — 0,5–1 г 2 once a day. Against the background of kidney dysfunction (depending on the severity of) - 1 g in 12 or 24 no, or 0,5 г каждые 24–48 ч. Children 2 admission, aged 2 Months: 25-50 Mg / kg / day, senior 2 мес — 50–100 мг/кг/сут.

Precautions.

With the development of an allergic reaction to ceftazidime should be lifted immediately, in severe cases may require epinephrine, hydrocortisone, antihistamine drugs and conduct other emergency measures.

At the same time taking the high dose of cephalosporins with nephrotoxic drugs such, as the aminoglycosides and diuretics (furosemid), You need to monitor renal function.

Since ceftazidime eliminated via the kidneys, patients with renal insufficiency, the dose should be reduced according to the degree of renal dysfunction.

Prolonged use of broad spectrum antibiotics, incl. and ceftazidime, It may lead to increased growth of microorganisms insensitive (eg Candida, Enterococci), This may require discontinuation of treatment or appropriate therapy. During treatment, you must continually assess the patient's condition.

Ceftazidime in the treatment of some initially susceptible strains Еnterobacter and Serratia may develop resistance, therefore, in the treatment of infections, caused by these microorganisms, should periodically conduct a study on the sensitivity to antibiotics.

Cooperation