a broad-spectrum third-generation cephalosporin antibiotic effective against many different types of infections caused by susceptible organisms.
Fortaz, Fortum (UK), Tazicef
Pharmacologic class: Third-generation cephalosporin
Therapeutic class: Anti-infective
Pregnancy risk category B
Interferes with bacterial cell-wall synthesis and division by binding to cell wall, causing cell to die. Active against gram-negative and gram-positive bacteria, with expanded activity against gram-negative bacteria. Exhibits minimal immunosuppressant activity.
Powder for injection: 500 mg, 1 g, 2 g, 6 g
Premixed containers: 1 g/50 ml, 2 g/50 ml
⊘Indications and dosages
➣ Skin infections; bone and joint infections; urinary tract and gynecologic infections, including gonorrhea; respiratory tract infections; intraabdominal infections; septicemia
Adults and children ages 12 and older: For most infections, 500 mg to 2 g I.V. or I.M. q 8 to 12 hours. For pneumonia and skin infections, 0.5 to 1 g I.V. or I.M. q 8 to 12 hours. For bone and joint infections, 2 g I.V. or I.M. q 12 hours. For severe and life-threatening infections, 2 g I.V. q 8 hours. For complicated urinary tract infections (UTIs), 500 mg q 8 to 12 hours. For uncomplicated UTIs, 250 mg I.M. or I.V. q 12 hours.
Children ages 1 month to 12 years: 30 to 50 mg/kg I.V. q 8 hours
Neonates younger than 4 weeks: 30 mg/kg I.V. q 12 hours
• Renal impairment
• Febrile neutropenia
• Prophylaxis of perinatal infections
• Hypersensitivity to cephalosporins or penicillins
Use cautiously in:
• renal impairment, hepatic disease, biliary obstruction, phenylketonuria
• history of GI disease
• elderly patients
• pregnant or breastfeeding patients
• Obtain specimens for culture and sensitivity testing as necessary before starting therapy.
• Reconstitute powder for injection with sterile water, following manufacturer's directions for amount of diluent to use.
• For I.V. injection, dilute in sterile water as directed, and give single dose over 3 to 5 minutes. Inject into large vein; rotate injection sites.
• For intermittent I.V. infusion, dilute further with 100 ml of sterile water or another compatible fluid, such as normal saline solution or dextrose 5% in water. Infuse over 30 minutes.
• Don't dilute with sodium bicarbonate.
• For I.M. injection, reconstitute with sterile water, bacteriostatic water, or 0.5% or 1% lidocaine hydrochloride.
• When giving I.M., inject deep into large muscle mass.
CNS: headache, confusion, hemiparesis, lethargy, paresthesia, syncope, asterixis, neuromuscular excitability (with increased drug blood levels in renally impaired patients), seizures, encephalopathy
CV: hypotension, palpitations, chest pain, vasodilation
EENT: hearing loss
GI: nausea, vomiting, diarrhea, abdominal cramps, oral candidiasis, pseudomembranous colitis
GU: vaginal candidiasis, nephrotoxicity
Hematologic: lymphocytosis, eosinophilia, bleeding tendency, hemolytic anemia, hypoprothrombinemia, neutropenia, thrombocytopenia, agranulocytosis, bone marrow depression
Hepatic: hepatic failure, hepatomegaly
Skin: urticaria, maculopapular or erythematous rash
Other: chills, fever, superinfection, I.M. site pain, anaphylaxis, serum sickness
Drug-drug.Aminoglycosides, loop diuretics: increased risk of nephrotoxicity
Chloramphenicol: antagonism of ceftazidime's effects
Probenecid: decreased excretion and increased blood level of ceftazidime
Drug-diagnostic tests.Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, eosinophils, gamma-glutamyltransferase, lactate dehydrogenase: increased levels
Hemoglobin, platelets, white blood cells: decreased values
Coombs' test, urinary 17-ketosteroids, nonenzyme-based urine glucose tests (such as Clinitest): false-positive results
Drug-herbs.Angelica, anise, arnica, asafetida, bogbean, boldo, celery, chamomile, clove, danshen, fenugreek, feverfew, garlic, ginger, ginkgo, ginseng, horse chestnut, horseradish, licorice, meadowsweet, onion, papain, passionflower, poplar, prickly ash, quassia, red clover, turmeric, wild carrot, wild lettuce, willow: increased risk of bleeding
Monitor for extreme confusion, tonic-clonic seizures, and mild hemiparesis when giving high doses.
• Assess CBC and kidney and liver function test results.
• Monitor for signs and symptoms of superinfection and other serious adverse reactions.
• Be aware that cross-sensitivity to penicillins may occur.
• Instruct patient to report reduced urine output, persistent diarrhea, bruising, and bleeding.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.
effective against gram-positive and gram-negative bacteria.
indications It is prescribed for treatment of documented Pseudomonas aeruginosa infection and other bacterial infections of the lower respiratory tract, urinary tract, skin, abdomen, blood, bones and joints, and central nervous system.
contraindications It is contraindicated in patients who are hypersensitive to this product or to other cephalosporin antibiotics.
adverse effects Among adverse reactions reported are pruritus, fever, skin rash, diarrhea, eosinophilia, thrombocytosis, phlebitis, discomfort at the site of injection, and positive Coombs' test result.
drug. The drug is on the official list. Brand names are Fortum and Kefadim.
1. Pertaining to the ability to destroy or inhibit other living organisms.
2. A substance derived from a mould or bacterium, or produced synthetically, that destroys (bactericidal) or inhibits the growth (bacteriostatic) of other microorganisms and is thus used to treat infections. Some substances have a narrow spectrum of activity whereas others act against a wide range of both gram-positive and gram-negative organisms (broad-spectrum antibiotics). Antibiotics can be classified into several groups according to their mode of action on or within bacteria: (1) Drugs inhibiting bacterial cell wall synthesis, such as bacitracin, azithromycin false positive vancomycin and the β-lactams based agents (e.g. penicillin, cephalosporins (e.g. ceftazidime, ceftriaxone, cefuroxime). (2) Drugs affecting the bacterial cytoplasmic membrane, such as polymyxin B sulfate and gramicidin. (3) Drugs inhibiting bacterial protein synthesis, such as aminoglycosides (e.g. amikacin sulfate, framycetin sulfate, gentamicin, neomycin sulfate and tobramycin), tetracyclines, macrolides (e.g. erythromycin and azithromycin) and chloramphenicol. (4) Drugs inhibiting the intermediate metabolism of bacteria, such as sulfonamides (e.g. sulfacetamide sodium) and trimethoprim. (5) Drugs inhibiting bacterial DNA synthesis, such as nalixidic acid and fluoroquinolones (e.g. ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin and ofloxacin). (6) Other antibiotics such as fusidic acid, the diamidines, such as propamidine isethionate and dibrompropamidine. Syn. antibacterial. See antiinflammatory drug; fusidic acid.
a third generation cephalosporin antibiotic, active mainly against gram-negative bacteria and particularly Pseudomonas.
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