What is the use of Ceftazidime (a cephalosporin antibiotic)?

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Dainyal Siddiqui, MD

Internal Medicine

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Manuel Jimenez, MD

Cardiology

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Franz Pierre-Louis, MD

Infectious Disease

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Last updated: March 30, 2025 • View editorial policy

From the Guidelines

Ceftazidime is a third-generation cephalosporin antibiotic that should be used with caution due to increasing resistance rates, particularly in hospital-acquired infections, and its use should be guided by local epidemiology and susceptibility patterns 1.

Key Points

  • Ceftazidime is effective against Pseudomonas aeruginosa, making it valuable for treating hospital-acquired pneumonia, complicated urinary tract infections, and severe respiratory infections in cystic fibrosis patients.
  • The typical adult dosage ranges from 1-2 grams administered intravenously every 8 hours, with adjustments needed for patients with renal impairment.
  • Treatment duration typically ranges from 7-14 days depending on infection severity and clinical response.
  • Ceftazidime works by binding to penicillin-binding proteins and inhibiting bacterial cell wall synthesis, causing cell death.
  • Common side effects include pain at the injection site, diarrhea, and allergic reactions.
  • Patients with a history of severe penicillin allergy should use ceftazidime cautiously due to potential cross-reactivity.
  • Regular monitoring of renal function is recommended during treatment, especially in elderly patients or those with pre-existing kidney disease.

Use in Intra-Abdominal Infections

  • Ceftazidime can be used in combination with metronidazole for the treatment of intra-abdominal infections, particularly those caused by gram-negative bacteria, including Pseudomonas aeruginosa 1.
  • However, its use in patients with extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae infections is controversial, and alternative antibiotics such as carbapenems may be preferred 1.

Resistance and Susceptibility

  • Resistance to ceftazidime is increasing, particularly among Pseudomonas aeruginosa and Enterobacteriaceae isolates 1.
  • Local epidemiology and susceptibility patterns should guide the use of ceftazidime, and alternative antibiotics should be considered in areas with high resistance rates 1.

Newer Antibiotics

  • Newer antibiotics such as ceftolozane/tazobactam and ceftazidime/avibactam have been approved for the treatment of complicated intra-abdominal infections, including those caused by ESBL-producing Enterobacteriaceae and Pseudomonas aeruginosa 1.
  • These antibiotics may be valuable alternatives to ceftazidime in patients with suspected or confirmed resistance to ceftazidime 1.

From the FDA Drug Label

FORTAZ is indicated for the treatment of patients with infections caused by susceptible strains of the designated organisms in the following diseases:

  1. Lower Respiratory Tract Infections, including pneumonia, caused by Pseudomonas aeruginosa and other Pseudomonas spp.; Haemophilus influenzae, including ampicillin-resistant strains; Klebsiella spp.; Enterobacter spp. ; Proteus mirabilis; Escherichia coli; Serratia spp.; Citrobacter spp.; Streptococcus pneumoniae; and Staphylococcus aureus (methicillin-susceptible strains).
  2. Skin and Skin-Structure Infections caused by Pseudomonas aeruginosa; Klebsiella spp.; Escherichia coli; Proteus spp., including Proteus mirabilis and indole-positive Proteus; Enterobacter spp.; Serratia spp. ; Staphylococcus aureus (methicillin-susceptible strains); and Streptococcus pyogenes (group A beta-hemolytic streptococci).
  3. Urinary Tract Infections, both complicated and uncomplicated, caused by Pseudomonas aeruginosa; Enterobacter spp.; Proteus spp., including Proteus mirabilis and indole-positive Proteus; Klebsiella spp. ; and Escherichia coli.
  4. Bacterial Septicemia caused by Pseudomonas aeruginosa, Klebsiella spp., Haemophilus influenzae, Escherichia coli, Serratia spp., Streptococcus pneumoniae, and Staphylococcus aureus (methicillin-susceptible strains).
  5. Bone and Joint Infections caused by Pseudomonas aeruginosa, Klebsiella spp., Enterobacter spp., and Staphylococcus aureus (methicillin-susceptible strains).
  6. Gynecologic Infections, including endometritis, pelvic cellulitis, and other infections of the female genital tract caused by Escherichia coli.
  7. Intra-abdominal Infections, including peritonitis caused by Escherichia coli, Klebsiella spp., and Staphylococcus aureus (methicillin-susceptible strains) and polymicrobial infections caused by aerobic and anaerobic organisms and Bacteroides spp.
  8. Central Nervous System Infections, including meningitis, caused by Haemophilus influenzae and Neisseria meningitidis

Ceftazidime is used to treat various infections, including:

  • Lower Respiratory Tract Infections
  • Skin and Skin-Structure Infections
  • Urinary Tract Infections
  • Bacterial Septicemia
  • Bone and Joint Infections
  • Gynecologic Infections
  • Intra-abdominal Infections
  • Central Nervous System Infections 2

From the Research

Overview of Ceftazidime

  • Ceftazidime is a third-generation cephalosporin antibiotic effective against gram-negative bacteria, including Pseudomonas aeruginosa 3, 4, 5, 6.
  • It is administered intravenously or intramuscularly and has been used to treat various infections, including respiratory tract infections, urinary tract infections, and intra-abdominal infections 3, 7, 4, 5.

Efficacy of Ceftazidime

  • Studies have shown that ceftazidime is effective in treating serious infections caused by multiresistant gram-negative bacteria, including Pseudomonas aeruginosa 3, 4.
  • Ceftazidime-avibactam, a combination of ceftazidime and the beta-lactamase inhibitor avibactam, has been shown to be effective in treating complicated urinary tract infections and intra-abdominal infections caused by ceftazidime-resistant gram-negative bacteria 7, 6.
  • The clinical response to ceftazidime has been reported to be around 84-91% in various studies 3, 7, 4.

Safety and Tolerability

  • Ceftazidime has been reported to be well-tolerated, with minimal toxicity and few adverse events 3, 7, 4, 5.
  • The most common adverse events associated with ceftazidime-avibactam are gastrointestinal disorders, which are generally mild or moderate in intensity 7.
  • Resistance to ceftazidime has been reported, particularly in Pseudomonas aeruginosa isolates from patients with cystic fibrosis 4.
  • The emergence of multidrug-resistant and extensively drug-resistant Pseudomonas aeruginosa strains has highlighted the need for effective treatment options, including ceftazidime-avibactam 6.

References

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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