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Ceftazidime: a new approach in the treatment of moderate and severe infections
Abstract:
Ninety patients with serious infections, including 61 with septicaemia, pneumonia, peritonitis or meningitis, were treated with ceftazidime. Of these patients, 85.6% were clinically cured (73.3%) or improved (12.2%) by the antibiotic. In this study, 57.7% had infections due to Escherichia coli (24.7%), Klebsiella sp. (14.5%) and Pseudomonas sp. (18.5%). Two children with cystic fibrosis and Pseudomonas pneumonia and an adult with Legionella pneumonia responded well to ceftazidime treatment. Seventy patients had fever before treatment and most of them became apyrexial in less than 2 to 3 days. Ceftazidime was given either intramuscularly (42 patients) or intravenously (48 patients), in a dose of 1 g tds in 71 patients or 2 g tds in severe infections in 11 patients, or reduced to suit the renal function (7 patients) or in paediatric doses (2 children). Blood ceftazidime levels were measured in eight patients with normal renal function. The average level one hour post dosing was 45.2 mg/l and the average trough level was 8.1 mg/l. Six patients were suffering from variable degrees of renal insufficiency (serum creatinine 149 to 668 mmol/l). Their average blood level 1 h post-dosing was 68.8 mg/l. In a patient with meningitis, the CSF level was 2.4 mg/l 2 h after a 1 g dose. These levels are several times the ceftazidime MIC values for most clinical bacterial isolates. Ceftazidime is a valuable and safe alternative to aminoglycoside therapy.
Insights
Ceftazidime effectively treated serious infections in 90 patients, achieving an 85.6% cure or improvement rate. This antibiotic demonstrated safety and efficacy, offering a valuable alternative to aminoglycosides for bacterial infections.
Area of Science:
- Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Serious bacterial infections pose significant treatment challenges.
- Aminoglycosides are commonly used but can have toxicity concerns.
- Ceftazidime is a third-generation cephalosporin with broad-spectrum activity.
Purpose of the Study:
- To evaluate the clinical efficacy and safety of ceftazidime in patients with serious infections.
- To assess the pharmacokinetic profile of ceftazidime in patients with normal and impaired renal function.
- To compare ceftazidime's effectiveness against common bacterial pathogens.
Main Methods:
- Prospective study of 90 patients with serious infections treated with ceftazidime.
- Clinical outcomes (cure, improvement, failure) were assessed.
- Bacterial pathogens were identified, and minimum inhibitory concentrations (MICs) were determined.
- Blood and cerebrospinal fluid (CSF) ceftazidime levels were measured in select patients.
Main Results:
- 85.6% of patients achieved clinical cure (73.3%) or improvement (12.2%).
- Effective against common pathogens like Escherichia coli, Klebsiella sp., and Pseudomonas sp.
- Rapid defervescence observed in febrile patients.
- Achieved therapeutic drug levels, even in patients with renal insufficiency.
Conclusions:
- Ceftazidime is a highly effective and safe antibiotic for treating serious bacterial infections.
- It offers a valuable alternative to aminoglycoside therapy.
- Demonstrated good penetration into CSF and effective treatment of specific infections like Pseudomonas pneumonia and meningitis.