Broad gram negative coverage including Pseudomonas, generally used for nosocomial infections including post-neurosurgical meningitis, or other infections based on susceptibilities.

Notable lack of gram positive activity versus other cephalosporins.

Tier 2 Protected Antimicrobial

• Broad spectrum, but 1st line for common infections, comes with a high risk of poor stewardship if initial workup and follow-up are not in place

Strategies Used:

1. Appropriate workup initially
2. Pharmacists audit/de-escalate
3. Set EBM Duration

• Renal function (nephrotoxicity)
• neurotoxicity
• PT/INR for patient at risk of elevations

Allergy (immediate and delayed).

• Note potential cross-reactivity with aztreonam based on side chain.

Pruritis, skin rash, IV site reactions

Positive Coombs, eosinophilia

Increased hepatic enzymes

• Chloramphenicol: diminish therapeutic effect of Ceftazidime
• Aminoglycosides: enhance nephrotoxic effects of AGs
• Probenecid: increase concentration of cephalosporins
• Vitamin K Antagonists: enhance anticoagulant effect of warfarin

Antimicrobial class: 3rd generation Cephalosporin

Pregnancy category: B

Average serum half life: 2 hours

• Pre-term neonates: PNA 3 days half-life 8.7 hours, PNA 10 days half-life 5 hours

Urine penetration: Therapeutic, 80-90% of drug excreted unchanged into urine

Lung penetration: Therapeutic

CSF penetration: Therapeutic, higher concentration when meninges are inflamed

Biliary penetration: Moderate

Bone penetration: Therapeutic