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Ceftazidime. An update of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy
C P Rains1, H M Bryson, D H Peters
1Adis International, Auckland, New Zealand.
Abstract:
Ceftazidime is a third generation cephalosporin antibacterial agent which, since its introduction in the early 1980s, has retained a broad spectrum of in vitro antimicrobial activity and clinical utility in serious infections. However, increasing resistance to ceftazidime and other third generation cephalosporins, particularly among Enterobacteriaceae, due to the emergence of plasmid-mediated extended spectrum beta-lactamases and the class I chromosomally mediated beta-lactamases, is of concern. There is now a wealth of information on the pharmacokinetics of the drug. enabling ceftazidime to be used predictably, and with a low potential for adverse effects, in a diversity of patient populations. Overall, ceftazidime remains an effective agent for the treatment of serious infection, particularly those due to major nosocomial pathogens, and respiratory infections in patients with cystic fibrosis. Ceftazidime-containing regimens also remain an important option for the empirical therapy of febrile episodes in neutropenic patients. The tolerability profile of ceftazidime makes the drug a useful option in seriously ill patients who are at risk of developing adverse events with other antibacterial agents. Although patterns of bacterial resistance have changed in the ensuing years since its introduction, judicious use of this important agent will help maintain its present clinical utility.
Insights
Ceftazidime, a third-generation cephalosporin, remains effective for serious infections despite rising bacterial resistance. Judicious use is key to maintaining its clinical utility against common pathogens.
Area of Science:
- Pharmacology and Infectious Diseases
Background:
- Ceftazidime, a third-generation cephalosporin, introduced in the early 1980s, offers broad-spectrum antimicrobial activity.
- It has demonstrated clinical utility in treating serious infections, including nosocomial pathogens and respiratory infections in cystic fibrosis patients.
Purpose of the Study:
- To review the pharmacokinetic data and clinical utility of ceftazidime.
- To discuss the impact of emerging bacterial resistance on ceftazidime's effectiveness.
- To highlight ceftazidime's role in empirical therapy for neutropenic patients.
Main Methods:
- Review of existing pharmacokinetic data.
- Analysis of in vitro antimicrobial activity and clinical outcomes.
- Assessment of bacterial resistance patterns, including extended-spectrum beta-lactamases (ESBLs) and chromosomally mediated beta-lactamases.
Main Results:
- Ceftazidime exhibits predictable pharmacokinetics, allowing safe use across diverse patient populations with a low potential for adverse effects.
- Despite increasing resistance, particularly among Enterobacteriaceae, ceftazidime remains effective against major nosocomial pathogens.
- It is a valuable option for empirical treatment of febrile episodes in neutropenic patients and for respiratory infections in cystic fibrosis.
Conclusions:
- Ceftazidime continues to be an effective agent for serious infections, especially those caused by nosocomial pathogens.
- Its favorable tolerability profile makes it suitable for critically ill patients.
- Judicious use of ceftazidime is essential to preserve its clinical efficacy amidst evolving resistance patterns.