• Treatment of the following infections caused by susceptible organisms:
  • Skin and skin structure infections,
  • Bone and joint infections,
  • Urinary tract infections,
  • Gynecological infections,
  • Lower respiratory tract infections,
  • Intra-abdominal infections,
  • Septicemia,
  • Febrile neutropenia,
  • Meningitis.

Contraindicated in:

• Hypersensitivity to cephalosporins
• Serious hypersensitivity to penicillins.

Use Cautiously in:

• Renal impairment (↓ dosing/↑ dosing interval recommended if CCr ≤50 mL/min)
• History of GI disease, especially colitis
• Lactation: Direct drug effects and modification of bowel flora may occur in the nursing infant
• Geri: Dose adjustment may be necessary due to age-related ↓ in renal function.

Derm: rash, pruritus, urticaria.

GI: CLOSTRIDIOIDES DIFFICILE-ASSOCIATED DIARRHEA (CDAD), abdominal pain, diarrhea, nausea, vomiting.

Hemat: bleeding, blood dyscrasias, hemolytic anemia.

Local: pain at IM site, phlebitis at IV site.

Neuro: encephalopathy, SEIZURES (HIGH DOSES IN PATIENTS WITH RENAL IMPAIRMENT).
Misc: fever, (INCLUDING ANAPHYLAXIS) HYPERSENSITIVITY REACTIONS, superinfection.

Drug-Drug:

• Concurrent use of loop diuretics or nephrotoxic agents including aminoglycosides may ↑ risk of nephrotoxicity.
• Bactericidal activity ↓ by chloramphenicol.

(Generic available)

• Powder for injection: 1 g/vial; 2 g/vial; 6 g/vial;
• Premixed infusion: 1 g/50 mL; 2 g/50 mL;

• IM, IV (Adults and Children ≥12 yr): Pneumonia and skin/skin structure infections: 500 mg–1 g every 8 hr. Bone and joint infections: 2 g every 12 hr.Severe and life-threatening infections: 2 g every 8 hr.Complicated urinary tract infections: 500 mg every 8–12 hr.Uncomplicated urinary tract infections: 250 mg every 12 hr.Cystic fibrosis lung infection caused by Pseudomonas aeruginosa: 30–50 mg/kg every 8 hr (max daily dose = 6 g).
• IM, IV (Children 1 mo–12 yr): 100–150 mg/kg/day divided every 8 hr (maximum dose:6 g/day).
• IM, IV (Neonates ≤4 wk): 50 mg/kg every 8–12 hr.

Fortaz, Tazicef

• Binds to the bacterial cell wall membrane, causing cell death.

• Bactericidal action against susceptible bacteria.

Spectrum:

• Similar to that of second-generation cephalosporins, but activity against staphylococci is less, while activity against gram-negative pathogens (particularly Pseudomonas aeruginosa) is greater, even for organisms resistant to first- and second-generation agents.
• Notable is increased action against:
  • Citrobacter,
  • Enterobacter,
  • Haemophilus influenzae(including -lactamase-producing strains),
  • Escherichia coli,
  • Klebsiella pneumoniae,
  • Neisseria meningitidis,
  • Proteus,
  • Providencia,
  • Pseudomonas aeruginosa,
  • Serratia,
  • Moraxella catarrhalis.
• Not active against methicillin-resistant staphylococci or enterococci.

Therapeutic Classification: anti-infectives

Pharmacologic Classification: third generation cephalosporins

Absorption: Well absorbed following IM administration; IV administration results in complete bioavailability.

Distribution: Widely distributed. Crosses the placenta; enters breast milk in low concentrations. CSF penetration better than with first- and second-generation agents.

Protein Binding: 17%.

Metabolism/Excretion: 80–90% excreted unchanged in urine.

Half-life: Neonates: 2.2–4.7 hr; Adults: 2 hr (↑ in renal impairment).

• Advise patient to report signs of superinfection (furry overgrowth on the tongue, vaginal itching or discharge, loose or foul-smelling stools) and allergy.
• Instruct patient to notify health care professional if fever and diarrhea develop, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional.
• Advise females of reproductive potential to notify health professional if pregnancy is planned or suspected or if breastfeeding. Monitor infants exposed to ceftazidime for GI disturbances (thrush or diarrhea).

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