Ceftazidime + Tazobactam Overview
Ceftazidime + Tazobactam is a combination antibiotic consisting of ceftazidime (a third-generation cephalosporin) and tazobactam (a beta-lactamase inhibitor). This combination expands the antibacterial spectrum by protecting ceftazidime from being broken down by beta-lactamase enzymes, which are produced by certain resistant bacteria. This makes it highly effective against a wide range of infections caused by gram-positive, gram-negative, and some anaerobic bacteria.
Available Forms and Strengths
- Intravenous infusion:
- Ceftazidime 2 g + Tazobactam 0.25 g (2.25 g vial)
- Ceftazidime 1 g + Tazobactam 0.125 g (1.125 g vial)
- Ceftazidime 1 g + Tazobactam 0.125 g (1 g vial)
These are typically mixed with sterile water or saline solution for intravenous (IV) infusion.
Uses of Ceftazidime + Tazobactam
- Complicated urinary tract infections (UTIs): Particularly in cases caused by resistant organisms.
- Complicated intra-abdominal infections: Often used in combination with metronidazole to treat polymicrobial infections.
- Hospital-acquired pneumonia (HAP): Including ventilator-associated pneumonia, especially caused by multidrug-resistant organisms like Pseudomonas aeruginosa.
- Severe skin and soft tissue infections: Especially in immunocompromised patients or those with resistant bacteria.
- Bacteremia: In bloodstream infections caused by susceptible bacteria, including drug-resistant strains.
- Febrile neutropenia: Empirical therapy in neutropenic patients with fever, particularly when gram-negative pathogens are suspected.
Side Effects of Ceftazidime + Tazobactam
- Gastrointestinal issues: Nausea, vomiting, diarrhea, and abdominal pain.
- Allergic reactions: Rash, itching, swelling, or in rare cases, anaphylaxis.
- C. difficile-associated diarrhea: Prolonged use can lead to overgrowth of Clostridium difficile, causing severe diarrhea.
- Injection site reactions: Pain, redness, or swelling at the injection site.
- Liver enzyme elevations: May cause temporary increases in liver function tests.
- Hematologic issues: Neutropenia, thrombocytopenia, and rarely, hemolytic anemia can occur during treatment.
Dosage Guidelines
- Adults: The standard dosage is 2.25 g (2 g ceftazidime + 0.25 g tazobactam) intravenously every 8 hours, depending on the type and severity of the infection.
- Pneumonia: 2.25 g IV every 8 hours for 7-14 days.
- Complicated UTIs: 2.25 g IV every 8 hours for 7-14 days.
- Intra-abdominal infections: 2.25 g IV every 8 hours, usually combined with metronidazole for better anaerobic coverage.
- Renal impairment: Dose adjustments are required based on the degree of renal function impairment.
- Mild impairment: 2.25 g every 12 hours.
- Moderate to severe impairment: Dosage intervals may be extended to every 24 hours.
Important: Ceftazidime + Tazobactam should only be administered in a hospital setting under the supervision of a healthcare professional.
Contraindications
- Allergy to cephalosporins, penicillins, or beta-lactam antibiotics: Cross-reactivity between these antibiotic classes can occur, leading to severe allergic reactions.
- Severe renal dysfunction: Requires close monitoring and dose adjustment.
- History of beta-lactamase inhibitor hypersensitivity: Patients with known reactions to tazobactam or similar inhibitors should not use this combination.
Warnings and Precautions
- Allergic reactions: Like other beta-lactams, this combination can cause serious hypersensitivity reactions. Patients with a history of penicillin or cephalosporin allergy should use this drug cautiously.
- Renal function monitoring: Ceftazidime + Tazobactam is eliminated primarily through the kidneys, so kidney function should be regularly monitored, especially in elderly patients or those with pre-existing kidney disease.
- Superinfection risk: Prolonged use of broad-spectrum antibiotics like ceftazidime + tazobactam may result in the overgrowth of non-susceptible organisms, such as C. difficile, leading to severe diarrhea.
- Hepatic dysfunction: Patients with liver disease should be monitored for potential liver damage, as ceftazidime + tazobactam can elevate liver enzymes.
Special Instructions
- Administration: This medication must be administered slowly as an intravenous infusion, typically over 30 to 60 minutes.
- Hydration: Adequate hydration is recommended to prevent renal toxicity.
- Storage: Reconstituted vials must be stored properly and used within a specified timeframe to maintain effectiveness.
- Avoid excessive use: Caution against overuse, especially in patients at risk for drug-resistant bacterial infections.
- Cross-reactivity with penicillin: Patients with a known penicillin allergy should be closely monitored for any cross-reactive allergic reactions.
Drug Interactions
- Aminoglycosides: Concurrent use may increase the risk of nephrotoxicity, so kidney function should be carefully monitored if used together.
- Loop diuretics: Increased risk of kidney damage when used together with diuretics like furosemide.
- Oral anticoagulants: Ceftazidime + tazobactam may alter the effectiveness of warfarin or other anticoagulants, potentially increasing the risk of bleeding.
- Probenecid: May increase blood levels of ceftazidime by decreasing renal excretion, potentially leading to toxicity.
Ceftazidime + Tazobactam is a potent combination used primarily in hospital settings to treat serious, resistant infections. It is effective against a broad range of pathogens but requires careful monitoring for potential side effects and drug interactions.
