Parenteral Manual

Ceftazidime

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
FORTAZ®, TAZIDIME®
Classification: 
Antibiotic
Original Date: 
August 2005
Revised Date: 
November 2021
Indications: 
  • 3rd generation cephalosporin, usually reserved for multiple-resistant gram negative rods
  • Main indication is for treatment of infections due to pseudomonas aeruginosa
  • Empiric therapy for febrile neutropenia in patients with penicillin allergy
Reconstitution and Stability: 
VIAL SIZE STERILE WATER for INJECTION REQUIRED FINAL CONCENTRATION
1,000 mg 10 mL 100 mg/mL
2,000 mg 18.3 mL 100 mg/mL
6,000 mg 56 mL 100 mg/mL
  • Reconstituted solutions stable 8 hours room temperature, 48 hours refrigerated for bulk pharmacy vials
  • Protect vials from light                
  • Vent vials - addition of diluent generates positive pressure within the vial
  • Expel any CO2 bubbles that may be present in withdrawn solution prior to injection
  • Diluted in D5W or 0.9% 0.9% NaCl (10-20 mg/mL) stable 7 days refrigerated, 24 hrs at room temperature
Compatibility: 

- Solutions Compatible: dextrose up to D10W, 0.9% NaCl, dextrose-saline combinations, ringer's solution, ringer's lactate

-Additives/Above Cassette Compatible: KCl (up to 40 mmoL/mL), lidocaine

- Y-site Compatible: morphine, ondansetron, ranitidine, TPN (amino acids/dextrose), furosemide, hydromorphone

- Incompatible: aminoglycoside antibiotics [administration of aminoglycoside and beta lactam antibiotics should be separated], amiodarone, azithromycin, midazolam, vancomycin

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM

YES, deep into large muscle
Usual dilution: 280 mg/mL
IV Direct

YES
Usual dilution: 100 mg/mL
- 20 mg/mL for dose less than 200 mg

Infusion 3-5 minutes
IV Intermittent Infusion

YES
Usual dilution: 100 mg/mL

 - 20 mg/mL for dose less than 200 mg
Infusion time: 15-30 minutes
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

PEDIATRIC:         

  • 150 mg/kg/day IV/IM ÷ Q8H
     Maximum: 6g/day
  • Cystic Fibrosis: 200 - 300 mg/kg/day ÷ Q 6 hours
    Maximum: 12g/day

ADOLESCENT/ADULT:

  • 1-2 g IV/IM Q 8 hours

 DOSAGE ADJUSTMENT IN RENAL IMPAIRMENT:

  • CrCl  30-50 mL/minute:  Administer Q 12 hours
  • CrCl  10-30 mL/minute:  Administer Q 24 hours
  • CrCl  < 10 mL/minute:    Administer Q 24-48 hours
Potential hazards of parenteral administration: 
  • Pain after IM injection   
  • Phlebitis with IV administration                          
  • Risk of hypersensitivity reaction; rash, urticaria, laryngoedema, larynogospasm, anaphylaxis
  • Transient elevation of liver enzymes, jaundice, hyperbilirubiniemia
  • Colitis, diarrhea, nausea, candidiasis, vomiting 
  • Hematologic - transient leukopenia, neutropenia, thrombocytopenia, agranulocytosis, lymphocytosis, hemolytic anemia, eosinophilia
Notes: 
  • With prolonged therapy monitor renal, hepatic and hematologic function periodically
  • Cross-sensitivity (5-10% of patients) has been demonstrated between penicillins and cephalosporins; patients with a reported allergy to penicillins should be observed closely for evidence of rashes, urticaria, wheezing or anaphylaxis.
  • Sodium content is 2.3 mmol/gm ceftazidime
  • False positive Coombs test

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