The drug is used intravenously and intramuscularly.
The dose of the drug is determined individually, taking into account the severity of the disease, localization of infection and sensitivity of the pathogen, age and body weight, kidney function.
Intravenously, the drug can be injected directly into the vein or tube of the infusion system if the patient receives infusion therapy.
Intramuscularly the drug is injected deep into the muscle mass, for example, into the upper outer quadrant of the gluteus maximus or the lateral surface of the thigh.
Adults and children with a body weight of 40 kg and more
- Usually the recommended dose is 1-6 g in 2 or 3 injections intravenously or intramuscularly;
- with bronchopulmonary bacterial infection in cystic fibrosis, 100-150 mg / kg / day in 3 administrations are prescribed (the maximum daily dose is 9 g)1;
- with febrile neutropenia due to bacterial infection, nosocomial pneumonia, bacterial meningitis, bacteremia appoint 2 g every 8 hours;
- for infections of bones and joints, complicated infections of the skin and soft tissues, infections of the ENT organs, complicated intra-abdominal infections, peritonitis associated with hemo- and peritoneal dialysis and with continuous ambulatory peritoneal dialysis, 1-2 g every 8 hours are prescribed;
- in infections of the gastrointestinal tract and biliary tract - 1 g every 8 hours or 2 g every 12 hours;
- in severe infections, especially in patients with reduced immunity (including patients with neutropenia), 2 grams every 8 or 12 hours or 3 g every 12 hours;
- with complicated infections of the urinary tract, it is recommended to inject 1-2 g every 8 or 12 hours.
For the prevention of prostate surgery (transurethral resection) ceftazidime prescribe a dose of 1 g during induction anesthesia and a second dose is administered when the catheter is removed.
Mode of prolonged infusion
If febrile neutropenia due to bacterial infection, bacterial broncho-pulmonary infections in cystic fibrosis, nosocomial pneumonia, bacterial meningitis, bacteremia, bone and joint infections, complicated infections of the skin and soft tissues, complicated intra-abdominal infections, peritonitis related to the hemo and peritoneal dialysis and with continuous ambulatory peritoneal dialysis, the drug is administered as a loading dose of 2 g with subsequent administration of the drug in the regime of prolonged infusion in doses from 4 to 6 g every 24 hours1.
1 In adults with normal renal function, when the drug was administered at a dose of up to 9 g per day, no side effects were observed.
Special patient groups
Children older than 2 months with a body weight of less than 40 kg
- for infections of the gastrointestinal tract and bile ducts, 30-100 mg / kg / day in 2 or administration is prescribed;
- with infections of the ENT organs (chronic purulent otitis media, malignant external otitis), complicated infections of bones and joints, complicated infections of the skin and soft tissues, complicated intra-abdominal infections, peritonitis associated with hemo- and peritoneal dialysis and with continuous ambulatory peritoneal dialysis , appoint 100-150 mg / kg / day in 3 injections, maximum - 6 g / day;
- with febrile neutropenia, bronchopulmonary bacterial infection in cystic fibrosis, bacterial meningitis, severe infections such as septicemia, bacteremia, infections in patients with immunodeficiency, 150 mg / kg / day in 3 injections, maximum - 6 g / day.
Mode of prolonged infusion
With febrile neutropenia due to bacterial infection, bronchopulmonary bacterial infection in cystic fibrosis, nosocomial pneumonia, bacterial meningitis,bacteremia, bone and joint infections, complicated infections of the skin and soft tissues, complicated intra-abdominal infections, peritonitis associated with hemo- and peritoneal dialysis and with continuous outpatient peritoneal dialysis, ceftazidime injected as a loading dose of 60-100 mg / kg, followed by the introduction of the drug in the regime of prolonged infusion at a dose of 100-200 mg / kg / day, a maximum of 6 g / day.
Newborns aged 0 to 28 days and children between the ages of 28 days and up to 2 months
Enter for 25-60 mg / kg / day in 2 injections.
Mode of prolonged infusion
Safety and effectiveness of ceftazidime in the regime of prolonged infusion in newborns from 0 to 28 days and in children from 28 days to 2 months have not been studied.
Elderly patients
Given the reduced clearance of ceftazidime, the recommended dose of ceftazidime in elderly patients should not exceed 3 g / day, especially in patients older than 80 years.
Patients with impaired renal function
Ceftazidime is excreted by the kidneys unchanged. Therefore, in patients with impaired renal function, the dose of ceftazidime should be reduced.
The initial dose is 1 g; maintenance doses are selected depending on the values of creatinine clearance.
Adults and children with a body weight of 40 kg and more
Supportive doses of ceftazidime for patients with impaired renal function
| Clearance creatinine (ml / min) | Concentrations creatinine in blood plasma, μmol / L (mg / dl) | Recommended single dose and frequency of administration |
| >50 | < 150 (<1,7) | Standard doses |
| from 50 to 31 | 150 to 200 (from 1.7 to 2.3) | 1 g every 12 h |
| from 30 to 16 | from 200 to 350 (2.3 to 4.0) | 1 g every 24 h |
| 15 to 6 | from 350 to 500 (4.0 to 5.6) | 500 mg every 24 hours |
| <5 | > 500 (> 5,6) | 500 mg every 48 hours |
For patients with severe infections, the recommended single dose should be increased by 50% or the frequency of administration of the drug is increased. In such patients, the concentration of ceftazidime in the blood plasma should be monitored (ceftazidime concentration should not exceed 40 mg / l). For children, the clearance of creatinine is calculated according to the fat-free body weight or surface area of the body.
Extended infusion regimen for patients with impaired renal function
Doses of ceftazidime for patients with impaired renal function when using the extended infusion regimen
| Clearance creatinine (ml / min) | Concentrations creatinine in blood plasma, μmol / L (mg / dl) | Recommended dose and frequency of administration |
| from 50 to 31 | 150 to 200 (from 1.7 to 2.3) | The loading dose of 2 g followed by by the introduction of 1-3 g for 24 hours in the regime of prolonged infusion |
| from 30 to 16 | from 200 to 350 (2.3 to 4.0) | The loading dose of 2 g followed by administration of 1 g for 24 hours in the regime of prolonged infusion |
| ≤15 | >350 (> 4,0) | Not evaluated |
Care should be taken when selecting a dose. A thorough clinical monitoring of the safety and effectiveness of the therapy is recommended.
Children with body weight less than 40 kg
Supportive doses of ceftazidime for patients with impaired renal function
| Clearance creatinine (ml / min) ** | Concentrations creatinine in blood plasma *, μmol / l (mg / dL) | Recommended dose and frequency of administration |
| from 50 to 31 | 150 to 200 (from 1.7 to 2.3) | 25 mg / kg body weight every 12 hours |
| from 30 to 16 | from 200 to 350 (2.3 to 4.0) | 25 mg / kg body weight every 24 hours |
| 15 to 6 | from 350 to 500 (4.0 to 5.6) | 12.5 mg / kg body weight every 24 hours |
| <5 | >500 (> 5,6) | 12.5 mg / kg body weight every 48 hours |
* Concentrations of creatinine in blood plasma are indicative and can not indicate the same degree of renal dysfunction for all patients.
** The calculation is based on body surface area or measurements.
In children with impaired renal function, the clearance of creatinine is determined according to the surface area of the body or the fat-free mass.
A thorough clinical monitoring of the safety and effectiveness of the therapy is recommended.
Extended infusion regimen for patients with impaired renal function
The efficacy and safety of ceftazidime introduced in the extended infusion regime in children with impaired renal function of body weight less than 40 kg have not been studied. A thorough clinical monitoring of the safety and effectiveness of the therapy is recommended. If extended infusion is used in children with impaired renal function, creatinine clearance should be calculated according to body surface area or lean body mass.
Hemodialysis
During hemodialysis, the elimination half-life is 3-5 hours. After each hemodialysis session, maintenance doses of ceftazidime are administered in accordance with the table given above.
Peritoneal dialysis
Ceftazidime can be used during peritoneal dialysis and continuous ambulatory peritoneal dialysis. In addition to intravenous administration ceftazidime can be added to the dialysis solution (usually at a dose of 125-250 mg per 2 liters of dialysis solution).
For patients with renal disease deficiency in continuous hemodialysis using an arteriovenous shunt, or for patients on high-speed haemofiltration in an intensive care unit, the recommended dose is 1 g / day daily (in one or more administrations).
For patients who are on hemofiltration at a low rate, the same doses of the drug are recommended, as in the case of disturbance of the function of the nights. Patients on hemodialysis or haemofiltration using a veno-venous shunt are recommended doses shown in the tables below.
Doses of ceftazidime in patients on hemofiltration using a veno-venous shunt
| Clearance creatinine (ml / min) | Maintenance dose (mg) depending on the rate of ultrafiltration (ml / min) * |
|
| 5 | 16,7 | 33,3 | 50 |
| 0 | 250 | 250 | 500 | 500 |
| 5 | 250 | 250 | 500 | 500 |
| 10 | 250 | 500 | 500 | 750 |
| 15 | 250 | 500 | 500 | 750 |
| 20 | 500 | 500 | 500 | 750 |
* The maintenance dose is given every 12 hours.
Doses of ceftazidime in patients on continuous hemodialysis using a veno-venous shunt
| Clearance creatinine (ml / min) | Maintenance dose (mg) depending on the rate of dialysis (ml / min) * |
|
| 1.0 l / h | 2.0 l / h |
| Rate of ultrafiltration (l / h) | Rate of ultrafiltration (l / h) |
| 0,5 | 1,0 | 2,0 | 0,5 | 1,0 | 2,0 |
| 0 | 500 | 500 | 500 | 500 | 500 | 750 |
| 5 | 500 | 500 | 750 | 500 | 500 | 750 |
| 10 | 500 | 500 | 750 | 500 | 750 | 1000 |
| 15 | 500 | 750 | 750 | 750 | 750 | 1000 |
| 20 | 750 | 750 | 1000 | 750 | 750 | 1000 |
* The maintenance dose is given every 12 hours.
Patients with impaired hepatic function
According to available data, there is no need for correction of the dosing regimen in patients with mild to moderate liver function impairment. There are no results of studies involving patients with impaired hepatic function.A thorough clinical monitoring of the safety and efficacy of the therapy is recommended.
Preparation of solutions
The drug is in vials under reduced pressure. When the powder is dissolved, carbon dioxide is released and the pressure in the vial is increased. As a result, small bubbles of carbon dioxide may be present in the prepared solution, which does not affect the effectiveness of the preparation.
Depending on the concentration, type of solvent and storage conditions, the resulting solution of the preparation may have a color from light yellow to dark yellow. If the rules of dilution of the drug are observed, then its effectiveness does not depend on the evaluation of the solution.
Preparation of solution for intramuscular or intravenous bolus administration
Insert the syringe needle into the vial through a rubber stopper and add solvent through it, as indicated in the table below:
| The amount of ceftazidime in the vial | Method introduction of | Solvent and its volume in ml | Approximate concentration, mg / ml |
| 250 mg | Intramuscularly | 1 ml of 0.5% or 1% solution of lidocaine hydrochloride or water for injections | 210 |
| Intravenously bolus | 2.5 ml of water for injection | 90 |
| 500 mg | Intramuscularly | 1.5 ml of 0.5% or 1% solution of lidocaine hydrochloride or water for injections | 260 |
| Intravenously bolus | 5 ml of water for injections | 90 |
| 1.0 g | Intramuscularly | 3 ml of 0.5% or 1% solution of lidocaine hydrochloride or water for injections | 260 |
| Intravenously bolus | 10 ml water for injection | 90 |
Take out the needle of the syringe and shake the bottle until a clear solution is formed. Turn the bottle and, with a piston fully inserted into the syringe, pierce the rubber bottle cap with a needle. Push the needle into the bottle so that it is in solution, and draw the whole solution into the syringe. The solution in the syringe can contain small bubbles of carbon dioxide.
The prepared solutions can be stored for 24 hours at a temperature of no higher than 25 ° C and not more than 7 days at a temperature of 2 ° C to 8 ° C (in the refrigerator).
Preparation of a solution for intravenous infusion (1 g bottles)
For the preparation of intravenous infusion, most of the most common infusion solutions can be used, including water for injection, 0.9% sodium chloride solution, Ringer's solution, 5% dextrose solution, 10% dextrose solution, 0.9% sodium chloride solution and 5 dextrose % (on the compatibility of ceftazidime in concentrations from 1 mg / ml to 40 mg / ml with the most common infusion solutions,section "Interaction with other medicinal products").
Caution: sodium bicarbonate is not recommended as a solvent (see the section "Interaction with other medicinal products").
| Dosage | Method introduction of | Volume of solvent in ml | Approximate concentration, mg / ml |
| 1 g | Intravenous infusion | 50 ml * | 20 |
* The addition of a solvent in the preparation of a solution for intravenous infusion is carried out in two stages:
1. Insert the syringe needle into the vial through a rubber stopper and add 10 ml of solvent through it. Take out the needle of the syringe and shake the bottle until a clear solution is formed. Insert the needle to exit the gas into the vial through a rubber stopper to reduce the internal pressure in the vial.
To ensure sterility, it is important not to inject the gas outlet needle into the bottle until the powder dissolves.
2. Transfer the prepared solution to the infusion system, bringing the total volume to at least 50 ml. Enter by intravenous infusion for 15-30 minutes.