Recommended Dosage of Intravenous Ceftazidime for Urinary Tract Infections
For uncomplicated urinary tract infections, the recommended dose of intravenous ceftazidime is 250 mg every 12 hours. For complicated urinary tract infections, the recommended dose is 500 mg every 8 to 12 hours. 1
Dosing Recommendations Based on UTI Type
Uncomplicated UTI
- 250 mg intravenous every 12 hours 1
- Treatment duration typically 5-7 days 2
- Consider oral step-down therapy after clinical improvement 2
Complicated UTI
- 500 mg intravenous every 8 to 12 hours 1
- Treatment duration of 7-14 days (14 days for men when prostatitis cannot be excluded) 2
- Dosage may need adjustment based on local resistance patterns and patient-specific factors 2
Dosage Adjustments for Special Populations
Renal Impairment
- For creatinine clearance 50-31 mL/min: 1 gram every 12 hours 1
- For creatinine clearance 30-16 mL/min: 1 gram every 24 hours 1
- For creatinine clearance 15-6 mL/min: 500 mg every 24 hours 1
- For creatinine clearance <5 mL/min: 500 mg every 48 hours 1
Hemodialysis Patients
- Loading dose of 1 gram, followed by 1 gram after each hemodialysis period 1
Pediatric Patients
- For infants and children (1 month-12 years): 30-50 mg/kg intravenous every 8 hours, to a maximum of 6 grams per day 1
- For neonates (0-4 weeks): 30 mg/kg intravenous every 12 hours 1
Clinical Considerations for UTI Treatment
Empiric Therapy Considerations
- Obtain urine culture before initiating therapy to guide subsequent treatment 2
- Consider local resistance patterns when selecting empiric therapy 2
- For severe infections or suspected multidrug-resistant organisms, higher doses may be warranted 2
Alternative Agents for UTIs
- For complicated UTIs caused by carbapenem-resistant Enterobacterales (CRE), ceftazidime-avibactam 2.5 g IV q8h is recommended 2
- Other options for complicated UTIs include fluoroquinolones, aminoglycosides, or extended-spectrum cephalosporins 2
Duration of Therapy
- Treatment should generally continue for 2 days after the signs and symptoms of infection have disappeared 1
- For complicated infections, longer therapy may be required 1
Evidence on Efficacy
- Clinical studies have demonstrated that ceftazidime is effective for both complicated and uncomplicated UTIs 3
- In comparative studies, ceftazidime has shown similar efficacy to other parenteral antibiotics for UTIs 4
- For ceftazidime-resistant pathogens, ceftazidime-avibactam has demonstrated high efficacy in the treatment of complicated UTIs 5, 6
Important Considerations and Pitfalls
- Ensure appropriate dose adjustment in patients with renal impairment to prevent toxicity 1
- Do not use ceftazidime for infections caused by known ceftazidime-resistant organisms unless combined with appropriate agents 2
- Monitor for clinical improvement within 48-72 hours; consider alternative therapy if no response 2
- For UTIs caused by multidrug-resistant organisms, combination therapy may be necessary 2
- Generally, ceftazidime should be continued for 2 days after the signs and symptoms of infection have disappeared 1