Mechanism of action
Ceftazidime belongs to beta-lactam antibiotics. Its action is based on disrupting bacterial cell wall synthesis. The drug exhibits high stability against many beta-lactamases produced by gram-negative microorganisms, allowing it to retain activity even under conditions of resistance to other antibiotics.
Pharmacological effects
The drug demonstrates an expanded spectrum of activity against gram-negative flora (E. coli, Proteus, Klebsiella, Enterobacter, Serratia, Citrobacter, Neisseria spp., H. influenzae). A key feature of ceftazidime is its highest activity among third-generation cephalosporins against Pseudomonas aeruginosa.
Indications and prescribing features
Ceftazidime is prescribed primarily for confirmed infections caused by Pseudomonas aeruginosa.
Dosing regimen:
- Intramuscularly: 0.5 g (in 1.5 ml of water) or 1.0 g (in 3 ml of water) every 8 hours.
- Intravenously: 0.5 g (in 5 ml of sterile water) administered slowly over 2–4 minutes.
Clinical application
Unlike some other third-generation cephalosporins (e.g., ceftriaxone), ceftazidime requires more frequent administration — every 8 hours. When working with the drug, it is important to consider that its activity against gram-positive flora is lower than that of first- and second-generation agents.
Briefly: answers to topical questions
For which infectious and inflammatory diseases is ceftazidime indicated?
Ceftazidime is used for infections caused by gram-negative flora, including:
- infections caused by Pseudomonas aeruginosa;
- leptospirosis during the second wave of fever and complications with multiorgan failure;
- non-fermenting gram-negative infection in cystic fibrosis;
- infections caused by Achromobacter spp. when therapy is chosen based on microorganism susceptibility;
- upper and lower respiratory tract infections and urinary tract infections as part of empirical therapy for febrile neutropenia in clinics with a low ESBL rate.
What are the absolute contraindications to prescribing ceftazidime?
An absolute contraindication to prescribing ceftazidime is hypersensitivity in the patient. This restriction is strictly considered when conducting antibacterial therapy for infections caused by non-fermenting gram-negative flora, including in pregnant patients with cystic fibrosis. If an individual intolerance to the antibiotic is identified, alternative medications are prescribed exclusively by decision of a medical board with mandatory documentation in the medical record.
Does ceftazidime cross the blood-brain barrier?
Yes. Ceftazidime belongs to third-generation cephalosporins, whose agents cross the blood-brain barrier. Due to this, third-generation cephalosporins are the drugs of choice for meningitis.
Ceftazidime is the "Blue" (pseudomonal) leader among the third generation.
Class and exam questions
Why is ceftazidime considered the drug of choice for pseudomonal infection?
Among all third-generation cephalosporins, ceftazidime possesses the most pronounced antibacterial activity against Pseudomonas aeruginosa.
Can ceftazidime be administered as an intravenous push?
Yes, the drug is administered intravenously as a bolus (jet), but slowly — over 2–4 minutes, after dissolving 0.5 g of powder in 5 ml of sterile water.
To which generation of cephalosporins does ceftazidime belong?
Ceftazidime belongs to the third generation of cephalosporins, which are characterized by high stability against beta-lactamases of gram-negative bacteria.
What else to study on this topic
- Comparative activity of third-generation cephalosporins against P. aeruginosa.
- Mechanisms of resistance development to beta-lactam antibiotics.
- Pharmacokinetic differences between ceftazidime and ceftriaxone.
- Principles of antibiotic selection in meningitis caused by gram-negative flora.
- Classification of cephalosporins by route of administration (parenteral vs. oral).
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