Ceftazidime

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

0.5–2 g every 8–12 hours Severe infections: 3 g every 12 hours Pseudomonal lung infections in cystic fibrosis: 100–150 mg/kg in 3 divided dosesSurgical prophylaxis: 1 g at induction

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :637.7

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :

<10 &nbsp &nbsp &nbsp &nbsp &nbsp :

%Excreted unchanged in urine &nbsp &nbsp : 80–90

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.28–0.4

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :2/13–25

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

31–50 1–2 g every 12 hours16–30 1–2 g every 24 hours6–15 500 mg – 1 g every 24 hours<5 500 mg – 1 g every 48 hours

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Dialysed. 500 mg – 1 g every 24 hours

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. 500 mg – 1 g every 24–48 hours

HDF/high flux &nbsp :Dialysed. 500 mg – 1 g every 24–48 hours

CAV/VVHD &nbsp &nbsp &nbsp:Dialysed. 2 g every 8 hours1 or 1–2 g every 12 hours1,2,3CVVhd/HDFDialysed. 2 g every 12 hours3

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anticoagulants: effects of coumarins may be enhanced

Ciclosporin: may cause increased ciclosporin levels

ADMINISTRATION

Reconstition

Amount of water for injection to be added to vials:

1.5 mL to 500 mg vial for IM administration

5 mL to 500 mg vial for IV injection

3 mL to 1 g vial for IM administration

10 mL to 1 g vial for IV injection —

Route

IV/IM rarely

Rate of Administration

Bolus: 3–4 minutes Infusion: over 30 minutes

Comments

May be given IP in fluid 50–125 mg/L fluid

Reconstituted solutions vary in colour, but this is quite normal

Compatible with most IV fluids, e.g. sodium chloride 0.9%, glucose-saline, glucose 5%

OTHER INFORMATION

Volume of distribution increases with infection

In exceptional circumstances, patients on haemodialysis may be given a dose of 2 g, 3 times a week post HD

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