Dose and Administration

1. 30-50 mg/kg/dose IV infusion by syringe pump over 30 minutes, or IM.

   Postmenstrual Age (weeks)	Postnatal Age (days)	Dosing Interval (hr)
   <29	0 to 28	12
   	> 28	8
   30 to 36	0 to 14	12
   	> 14	8
   37 to 44	0 to 7	12
   	> 7	8
   >45	All	6

Indications

1. Infections caused by organisms resistant to other antibiotics, including aminoglycosides and many cephalosporins.

Contraindications and Precautions

1. CNS infections with Streptococcal faecalis, Pseudomonas aerogenosa.
2. Caution in preterm infants, especially extreme immaturity.
3. Caution in infants with liver, renal or gastrointestinal disease.

Clinical Pharmacology

Bacteriocidal third generation cephalosporin antibiotic which is resistant to most beta-lactamases and is active against a wide range of gram positive and gram negative bacteria. Inactive against Streptococcus faecalis, many staphylococci and many strains of Bacteroides fragilis. A useful anti-pseudomonal agent, especially in combination with aminoglycosides or penicillin. Active by inhibiting cell wall mucopeptide synthesis.

Poor oral absorption. Widely distributed at varying concentrations in human body tissues and fluids. Very little passes into the CSF unless the meninges are inflamed. Low binding (10%) to human plasma protein. Ceftazadime is not metabolised in the body. Excreted via the kidney. Reduction in serum concentrations can be achieved by peritoneal dialysis/haemodialysis. Serum half life in neonates is 4-10 hours.

Possible Adverse Effects

1. Venous irritation, soft tissue injury at IV injection site.
2. Pain, soft tissue injury at IM injection site.
3. Rash, pruritus, urticaria.
4. Gastrointestinal disturbance (nausea, vomiting and diarrhoea).
5. Neutropaenia, thrombocytopaenia, eosinophilia.
6. Positive Coombs test.
7. Transient elevation of hepatic enzymes.

Special Considerations

1. Ceftazadime at high dosage should be given with caution to those infants receiving aminoglycosides or potent diuretics.
2. Adjust dose in suspected renal dysfunction (usually by lengthening the dosing interval).
3. Sodium content 2.3 mmol/gm.