Recommended Intravenous (IV) Dose of Ceftazidime for Adults
The standard adult IV dose of ceftazidime is 1 gram administered every 8 to 12 hours, with adjustments based on infection severity, pathogen susceptibility, and renal function. 1
Standard Dosing Regimens
- For most common infections, the usual recommended dosage is 1 gram IV every 8 to 12 hours 1
- For uncomplicated urinary tract infections, a lower dose of 250 mg IV every 12 hours is appropriate 1
- For more severe infections, higher doses are recommended:
- Bone and joint infections: 2 grams IV every 12 hours 1
- Complicated urinary tract infections: 500 mg IV every 8 to 12 hours 1
- Serious gynecologic and intra-abdominal infections: 2 grams IV every 8 hours 1
- Meningitis: 2 grams IV every 8 hours 1
- Very severe life-threatening infections, especially in immunocompromised patients: 2 grams IV every 8 hours 1
Specific Infection-Based Dosing
- For gram-negative enteric bacilli in infective endocarditis: 100-150 mg/kg/day IV divided every 8 hours up to 2-4 g daily 2
- For carbapenem-resistant Pseudomonas aeruginosa (CRPA) susceptible to ceftazidime: 2 g IV every 8 hours 2
Renal Adjustment Guidelines
Ceftazidime is primarily excreted by the kidneys through glomerular filtration, requiring dose adjustment in renal impairment 1:
- Creatinine clearance 50-31 mL/min: 1 gram every 12 hours 1
- Creatinine clearance 30-16 mL/min: 1 gram every 24 hours 1
- Creatinine clearance 15-6 mL/min: 500 mg every 24 hours 1
- Creatinine clearance less than 5 mL/min: 500 mg every 48 hours 1
Hemodialysis Considerations
- For patients on hemodialysis, a loading dose of 1 gram is recommended, followed by 1 gram after each hemodialysis session 1
- For patients with end-stage renal disease on low-flux hemodialysis, post-hemodialysis dosing of 1 gram provides adequate drug concentrations throughout the interdialytic period 3
Duration of Treatment
- Generally, ceftazidime should be continued for 2 days after signs and symptoms of infection have disappeared 1
- For complicated infections, longer therapy may be required 1
- For specific infections like carbapenem-resistant Pseudomonas aeruginosa, treatment duration of 5-14 days is recommended, with longer courses (10-14 days) for pneumonia and bloodstream infections 2
Administration Considerations
- Ceftazidime may be given intravenously as an infusion 1
- For critically ill patients, intermittent bolus dosing may result in variable plasma concentrations; some patients may have concentrations below the MIC for Pseudomonas aeruginosa 4
- Continuous infusion may be considered for critical infections to maintain consistent plasma levels 4
Monitoring
- For patients receiving prolonged courses, monitoring renal function is advisable as ceftazidime is primarily excreted by the kidneys 1
- In critically ill patients, therapeutic drug monitoring may be beneficial to ensure adequate plasma concentrations 4
Remember that while these are standard recommendations, the final dosing should consider the specific pathogen, its susceptibility pattern, the site and severity of infection, and the patient's clinical status.