Ceftazidime: therapeutic results in various infections and kinetic studies

Abstract

Forty-five patients with acute or recurrent pyelonephritis (32), lower respiratory infection (7) or various other serious infections (6), were treated with ceftazidime. Most infections were severe, often in the presence of aggravating factors, and had failed to respond to previous antibiotic therapy. Infecting organisms were Escherichia coli (23), other Enterobacteriaceae (5), Pseudomonas aeruginosa (11), mixed flora including Ps. aeruginosa (3) and Staphylococcus albus (1). The organisms were often multiresistant. Dosage ranged from 1 to 6 g daily im or iv. All patients were clinically cured, except two who only improved. In 35 patients the organisms were eradicated, in two partially eradicated, and in six persisted or recurred. Most bacteriological failures were observed in patients infected with Ps. aeruginosa. Tolerance of the drug was excellent. A transient leucopenia was observed in one patient and transient high SGOT and LDH in another. After an intramuscular dose of 1 g im serum levels were 33 mg/l at 2 h, 137 mg/l at 6 h and 85 mg/l at 12 h. The average half-life was 2.6 h. Urinary levels were high and 79-92% of the dose was recovered from the urine after 12 h. After 3 days therapy with 1 and 2 g im 12-hourly, bone levels exceeded 10 and 15 mg/l, respectively. Ceftazidime was a safe and effective drug for the treatment of infection. A dose of 0.5 g 12-hourly is sufficient for urinary infections, but higher doses are needed in other infections, especially when due to Ps. aeruginosa.

Pefloxacin versus ceftazidime in the treatment of a variety of gram-negative-bacterial infections

“…Even against this microorganism, pefloxacin and ceftazidime, a cephalosporin characterized by its major antipseudomonal activity (4,6,10), did not reveal any significant difference in efficacies.…”

“…Ceftazidime was selected as the comparative antibiotic because of its established favorable activity in the therapy of Pseudomonas aeruginosa and enterobacteriaceal infections (4,6,10). Animal model studies in which pefloxacin was compared with aminoglycosides or macrolides have been reported (8,27), but to our knowledge a similar comparative study with humans has not been published.…”

Effect of time interval on tissue concentrations of cephalosporins after tourniquet inflation: Highest levels achieved by administration 20 minutes before inflation

“…Among the cephalosporins we selected ceftazidime and ceftriaxone (third generation cephalosporins) and ceforanide (second generation cephalosporin) because they are widely used and have favorable pharmacokinetics (Daikos et al 1981, Kalager et al 1984). Thus, with three antibiotics high concentrations were readily achieved in all tissues, especially in muscle and skin, which were not different between the 10 and 20 min interval concentrations.…”

“…Among cephalosporins currently used in orthopedic prophylaxis, the second generation ceforanide, and the third generation celftazidime and ceftriaxone offer a wide antimicrobial cover (O'Gallaghan et al 1980, Seddon et al 1980, Daikos et al 1981). a high concentration in bone tissue (Leigh et al 1985) and a satisfactory 8-lactamase resistance (O'Gallaghan et al 1980).…”

Multiple-dose pharmacokinetics of amikacin and ceftazidime in critically ill patients with septic multiple-organ failure during intermittent hemofiltration

“…It may therefore offer a 04:00 6 08:00 6 20:00 9 06:00 9 10:15 9 20 wider spectrum of activity and a low incidence of toxicity. Ceftazidime was found to be safe and effective for treating a variety of serious infections mainly caused by P. aeruginosa (5,6). Aminoglycoside antibiotics are appropriate for use against this type of infection because of their broad gramnegative spectrum of activity.…”