From the Guidelines
Ceftazidime can be used as an empirical treatment for complicated urinary tract infections (UTIs) with systemic symptoms, as recommended by the European Association of Urology guidelines 1.
Key Considerations
- The use of ceftazidime for UTIs is generally reserved for complicated infections or those caused by resistant organisms, such as Pseudomonas aeruginosa.
- According to the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines 1, ceftazidime-avibactam is suggested for patients with severe infections due to carbapenem-resistant Enterobacterales (CRE) if active in vitro.
- For patients with non-severe infections due to CRE, the use of an old antibiotic, chosen from among the in vitro active ones, is considered good clinical practice 1.
Dosage and Administration
- The typical adult dose of ceftazidime is 1-2 grams administered intravenously every 8-12 hours for 7-14 days, depending on infection severity.
- Dosage adjustments are necessary for patients with renal impairment.
Important Notes
- Before initiating therapy, urine culture and sensitivity testing should be performed to ensure appropriate antibiotic selection 1.
- Common side effects of ceftazidime include gastrointestinal disturbances, rash, and potential for Clostridioides difficile infection.
- Patients should complete the full course of antibiotics even if symptoms improve before completion.
From the Research
Ceftazidime for UTI
- Ceftazidime-avibactam is a potential new agent for use in complicated urinary tract infections (UTIs) due to ceftazidime-resistant Gram-negative pathogens 2.
- The efficacy, safety, and tolerability of ceftazidime-avibactam compared with best available therapy in patients with complicated UTIs or complicated intra-abdominal infections due to ceftazidime-resistant Gram-negative pathogens were assessed in a phase 3 trial 2.
- The results showed that the overall proportions of patients with a clinical cure at the test-of-cure visit were similar with ceftazidime-avibactam and best available therapy 2.
Comparison with Other Antibiotics
- Cefepime, a fourth-generation cephalosporin, may be a valuable addition in the treatment of serious infections, including UTIs 3.
- A study comparing the efficacy and safety of cefepime and ceftazidime in hospitalized patients with complicated and uncomplicated UTIs found that cefepime produced a satisfactory clinical response in 89% of patients with complicated UTIs and eradicated 85% of pathogens 3.
- Ceftazidime-avibactam has good in vitro activity against Pseudomonas aeruginosa, a common pathogen in UTIs, relative to comparator β-lactam agents and fluoroquinolones 4.
Safety and Tolerability
- Ceftazidime-avibactam was well-tolerated, with a low incidence of adverse events, most of which were mild or moderate in intensity 2.
- The most common adverse events associated with ceftazidime-avibactam were gastrointestinal disorders, which were reported in 13% of patients 2.
- Cefepime was also well-tolerated, with a low incidence of adverse events, and local tolerance was similar to that of ceftazidime 3.