Drug reference

Ceftazidime

Cephalosporin · Antibiotic

Also known as Ceftazidime pentahydrate

START

Confirm gram-negative infection including Pseudomonas if suspected. Obtain cultures before first dose. Baseline renal function.

TYPICAL MAX

2 g IV q8h (6 g/day). Reduce in renal impairment.

STOP IF

Severe hypersensitivity, severe diarrhea (suspect CDAD), neurotoxicity (myoclonus, seizures)

WATCH

Renal function (adjust dose if CrCl <50), CDAD (diarrhea), neurotoxicity at high doses/renal impairment

CDSCO approvedSchedule HJan AushadhiATC J01DD02

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 30min · Immediate (IV)
PEAK: 1.5h · 1-2 h (IM)
t½: 2h · ~2 h (normal); 15-25 h (anuric)
DURATION: 8h · 8 h (q8h dosing)

EXCRETION

80-90% renal unchanged; minimal metabolism; not dialyzable

route + CYP

INTERACTIONS

—

none in our sources

PREGNANCY

FDA PLLR: Animal studies showed no teratogenicity. Limited human data. Crosses placenta. Generally considered safe in pregnancy (Category B old system).

FDA category + note

Available in India

493 branded formulations and 180 fixed-dose combinations. Look up specific brands in the Drugs workspace.

Jan Aushadhi — generic available at GoI pharmacies

Mechanism

Ceftazidime is a third-generation cephalosporin antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), primarily PBP-1 and PBP-3. This binding prevents cross-linking of peptidoglycan chains in the bacterial cell wall, leading to osmotic lysis of the bacterial cell. Ceftazidime is distinguished from other third-generation cephalosporins by its enhanced activity against Pseudomonas aeruginosa due to its unique C-7 side chain (pyridinium group) that confers stability against beta-lactamases produced by this organism.

Indications

Lower respiratory tract infections (including pneumonia)Skin and skin structure infectionsUrinary tract infections (including complicated)Intra-abdominal infections (in combination with metronidazole)Bacterial septicemiaBone and joint infectionsMeningitis (due to susceptible organisms)Pseudomonal infections (cystic fibrosis, hospital-acquired)

Dosing

Adult: 1-2 g IV/IM q8-12h. Pseudomonal infections: 2 g IV q8h. Uncomplicated UTI: 250-500 mg IV/IM q12h. Meningitis: 2 g IV q8h. Febrile neutropenia: 2 g IV q8h.
Pediatric: ≥1 month: 30-50 mg/kg IV q8h (max 6 g/day). Neonates 0-4 weeks: 30 mg/kg IV q12h.
Renal adjustment: CrCl 31-50: 1-2 g q12h. CrCl 16-30: 1-2 g q24h. CrCl 6-15: 0.5-1 g q24h. CrCl <5: 0.5-1 g q48h. HD: 1 g after each dialysis.
Hepatic adjustment: No adjustment required (minimal hepatic metabolism).
Geriatric: No adjustment for age alone. Adjust based on renal function.
Max dose: 6 g/day (adults); 6 g/day (pediatric, weight-based)

Pharmacokinetics

Onset

Rapid bactericidal activity; clinical response within 48-72 hours.

Peak effect

IV: immediate distribution. IM: peak at 1-2 hours.

Duration

8-12 hours (supports q8-12h dosing).

Half-life

~2 hours (normal renal function); prolonged to 15-25 hours in anuric patients.

Bioavailability

IM: ~80-90%. Not absorbed orally.

Protein binding

~10% (low; concentration-independent).

Metabolism

Not metabolized to any significant extent; excreted virtually unchanged.

Excretion

Renal: ~80-90% excreted unchanged in urine within 24 hours via glomerular filtration.

Contraindications

Hypersensitivity to ceftazidime, other cephalosporins, or beta-lactam antibiotics
History of anaphylaxis to penicillins (relative — cross-reactivity ~1-2% with IgE-mediated reactions)

Side effects

Common

Phlebitis at injection siteGI upset (nausea, diarrhea)RashElevated liver enzymes (transient)

Serious

Severe hypersensitivity (anaphylaxis, SJS/TEN — rare)
Clostridioides difficile-associated diarrhea (CDAD)
Neurotoxicity (myoclonus, seizures) at very high doses or in renal impairment without dose adjustment
Hemolytic anemia
Acute interstitial nephritis

Pregnancy & lactation

Pregnancy

FDA PLLR: Animal studies showed no teratogenicity. Limited human data. Crosses placenta. Generally considered safe in pregnancy (Category B old system).

Lactation

Excreted in breast milk in low concentrations. Compatible with breastfeeding per AAP. Monitor infant for diarrhea or candidiasis.

Drug interactions

Aztreonam

Moderate

Database

Shared side chain

Avoid if severe ceftazidime allergy