Ceftazidim-AKOS powder for solution 1g No. 1 bottle
Antimicrobial agents for systemic use. Cephalosporins and related substances.
Ceftazidime is a third-generation cephalosporin antibiotic. It has a bactericidal effect due to damage to the bacterial cell wall (acetylate membrane-bound transpeptidases, disrupting the cross-linking of peptidoglycans necessary to ensure the strength and rigidity of the cell wall). It has a wide spectrum of antimicrobial action. By different drug sensitive Gram positive: Staphylococcus aureus (strains sensitive to methicillin), St.epidermidis (strains sensitive to methicillin), Micrococcus spp, Streptococcus pneumoniae, Str.pyogenes, Str.agalactiae, Str.mitis, Streptococcus spp.. (excluding Streptococcus faecalis), Gram-negative: Aeromonas spp., Citrobacter spp., Enterobacter spp., Escherichia coli, H.influenzae, H.parainfluenzae, Klebsiella spp. (including K.pneumoniae), Morganella morganii, Providencia rettgeri, Providencia spp., Neisseria gonorrhoeae, N.miningitidis, Pasteurella multocida, Proteus mirabilis, P.vulgaris, Salmonella spp., Serratia spp. (including Serratia marcescens), Shigella spp., Yersinia spp. (including Yersinia enterocolitica), Acinetobacter spp. and anaerobic bacteria: Bacteroides spp. (Many strains of Bacteroides fragilis are resistant), Clostridium perfringers, Fusobacterium spp., Peptococcus spp., Peptostreptococcus, Propionibacterium spp.
The drug is resistant to beta-lactamase gram-positive and gram-negative bacteria.
With intramuscular and intravenous administration of ceftazidime, a high concentration of the drug in the blood plasma is quickly achieved (5–10 minutes after intravenous administration and 30–45 minutes after intramuscular administration). Cmax after intravenous administration is achieved in 20–30 minutes and ranges from 42 to 170 mcg / ml (depending on the dose). Therapeutic concentrations of the active substance in the blood plasma are maintained for 8–12 hours, depending on the dose and the route of administration. Ceftazidime binds to plasma proteins in less than 10%. It easily penetrates into sputum, into the tissues (including bone tissue) and fluids (synovial, pleural, peritoneal) of the organism, through the placental barrier. Poor penetrates through the blood-brain barrier, in a small amount into breast milk. In inflammation of the meninges, ceftazidime is found in therapeutic concentrations in the cerebrospinal fluid. Not metabolized.
Ceftazidime is derived predominantly (80–90%) by the kidneys in unchanged form within 24 hours. The half-life of the drug is 2 hours. In case of impaired renal function, the dose of the drug is reduced, since its half-life is extended (2.2 hours).
Method of use
The drug is used intramuscularly and intravenously.
The dose is set individually, depending on the pathogen, the severity of the disease, the patient's age, body weight, and renal function.
Solutions are prepared immediately before administration.
For intramuscular administration, dissolve 1.0 g of the drug in 3 ml of solvent (sterile water for injection or 0.5 - 1.0% lidocaine solution), injected deep in the upper outer quadrant of the gluteus maximus muscle or in the lateral thigh.
For intravenous injection, 1.0 g of the drug is dissolved in 10 ml of water for injection. The solution is injected slowly over 3 to 5 minutes.
For intravenous drip, the drug is additionally diluted in 150 - 400 ml of 5% glucose solution or isotonic sodium chloride solution. The solution is injected slowly over 1.5 - 2 hours.
The solution of the drug can be injected directly into the vein or into the tube of the infusion system.
Ceftazidime in powder form is in the vial under reduced pressure. When the powder is dissolved, carbon dioxide is released (in the form of small bubbles) and the pressure in the vial rises. Therefore, in order to facilitate use, it is recommended to observe the following method of preparing a solution for intramuscular or intravenous bolus administration:
1. Insert the needle of the syringe through the cap of the bottle and enter the recommended amount of solvent.
2. Remove the syringe needle and shake the vial for 1 to 2 minutes to obtain a clear solution.
3. Invert the vial. When the syringe piston is fully inserted, insert the needle into the vial cap so that the needle is completely in the solution and draw all the solution into the syringe (the needle should be in the solution).
Newborns and babies under 2 months. the drug is prescribed in a daily dose
25 - 50 mg / kg in 2 divided doses.
Children older than 2 months. the drug is prescribed in a daily dose of 50-100 mg / kg in 2 to 3 doses.
Children with reduced immunity in severe infections should be prescribed up to 150 mg / kg (maximum 6 g per day); the multiplicity of reception - 3 times a day.
Children over 12 years old and adults with most infections are prescribed 1 g every 8 hours or 2 g every 12 hours.
In severe cases of the disease, especially in patients with reduced immunity, including patients with neutropenia, 2 g every 8 or 12 hours should be administered, or 3 g every 12 hours. The maximum daily dose - 6 g.If necessary, you can increase the single dose by 50% or increase the frequency of drug administration, but in this case, the level of ceftazidime in the serum should be monitored, the concentration of the drug should not exceed 40 mg / l.
Adults with cystic fibrosis and lung infections caused by pseudomonads are prescribed ceftazidime in a dose of 100-150 mg / kg per day in 3 doses.
For urinary tract infections, the drug is prescribed in 0.5-1.0 g every 12 hours.
The dosage regimen for patients with impaired renal function is set depending on the values of creatinine clearance. The initial dose is 1 g. Maintenance doses recommended for adults:
Creatinine clearance (ml / min) Dosage regimen
50 - 31 1 g every 12 hours
30 - 16 1 g every 24 hours
15 - 5 500 mg every 24 hours
less than 5,500 mg every 48 hours
After each hemodialysis session, the maintenance doses of the drug are administered in accordance with the table above.
In peritoneal dialysis, in addition to intravenous administration, ceftazidime can be included in the dialysis solution (125 - 250 mg per 2 l of dialysis solution).
For adults with renal insufficiency who are on continuous hemodialysis using an arteriovenous shunt, and for patients who are on hemofiltration at a high rate in the intensive care unit, the recommended dose is 1 g per day (in one or several doses). For patients undergoing low-rate hemofiltration, doses recommended for impaired renal function are prescribed.
Elderly patients, taking into account the reduced clearance of the drug in acute diseases, it is recommended to prescribe ceftazidime in a dose of not more than 3 g per day, especially for patients over 80 years of age.
Allergic reactions (rash, fever, pruritus, eosinophilia; very rarely - bronchospasm, lowering blood pressure, angioedema), indigestion (nausea, vomiting, diarrhea, abdominal pain, rarely - stomatitis, colitis), neurological disorders (headache pain, dizziness, paresthesia, a violation of taste, in patients with renal insufficiency with improper dose selection - tremor, convulsions, encephalopathy), very rarely - leukopenia, neutropenia, thrombocytopenia, lymphocytosis.
Effects due to biological effects: Superinfection (candidiasis, including the vaginal mucosa).
Local reactions: phlebitis or thrombophlebitis when administered intravenously, sore at the site of intramuscular injection.
Indications for use
Ceftazidime is effective in the treatment of infections caused by susceptible microorganisms:
• for severe infections (septicemia, bacteremia, peritonitis, meningitis, infections in patients with reduced immunity; infections in patients in intensive care units);
• for respiratory tract infections (including lung infections and cystic fibrosis);
• with infections of the ear, nose, and throat;
• for urinary tract infections;
• with infections of the skin and soft tissues;
• with infections of the gastrointestinal tract, biliary tract, abdominal cavity;
• for infections of bones and joints;
• for infections of the pelvic organs;
• for infections associated with hemodialysis and peritoneal dialysis.
Interaction with other drugs
If necessary, to enhance the antibacterial activity against Pseudomonas aeruginosa, perhaps combined use of ceftazidime with aminoglycosides (gentamicin, amikacin). At the same time, to reduce the toxic effect, the drugs should be administered separately, both at the site of administration (with intramuscular injections) and in time (at intervals of not less than 1 hour).
May be used in combination with bronchodilators, mucolytic drugs, immunomodulators.
In the case of simultaneous use of ceftazidime and chloramphenicol, attention should be paid to the possible antagonistic action.
Simultaneous administration of ceftazidime (in high doses) and nephrotoxic drugs may have an adverse effect on renal function.
Symptoms: headache, dizziness, paresthesia, in severe cases - generalized seizures, encephalopathy, coma.
Treatment: maintenance of vital functions, hemodialysis, with the development of seizures - anticonvulsants. With the development of hypersensitivity reactions, the use of adrenaline, hydrocortisone, antihistamine drugs and other urgent measures are indicated.
Features of use
- With caution should use the drug for the treatment of newborns.
- Before starting treatment with ceftazidime, it is necessary to exclude the patient's hypersensitivity to antibiotics from the group of cephalosporins, penicillin and other drugs.
- If an allergic reaction to ceftazidime develops, the drug should be immediately discontinued.
- In renal insufficiency, ceftazidime doses are reduced in accordance with the degree of renal dysfunction.
- Prolonged use of the drug may lead to an increase in the growth of insensitive microorganisms (Candida, Enterococci), and this may require cessation of treatment or appropriate therapy.
It is a drug. Consultation with a doctor is required.