Ceftazidime

How it works

It inhibits bacterial cell-wall synthesis by binding penicillin-binding proteins and is relatively stable to many beta-lactamases, giving it strong activity against Pseudomonas aeruginosa and other Gram-negative bacilli.

Prescribing in practice

• Contraindicated in cephalosporin hypersensitivity and used with caution with a history of significant penicillin or beta-lactam allergy because of potential cross-reactivity.
• It has limited activity against Gram-positive organisms, so is not suitable as monotherapy where staphylococcal or streptococcal cover is needed.
• Renally excreted and requires dose adjustment in renal impairment, where accumulation can cause neurotoxicity.

Monitoring

Monitor renal function, clinical response, and consider effects on full blood count and liver enzymes during prolonged therapy.

Counselling the patient

• This is a hospital injectable antibiotic active against difficult Gram-negative bacteria.
• Report any rash, severe diarrhoea, or breathing difficulty.
• Tell staff about previous penicillin or cephalosporin allergy.

Evidence & guidelines

Ceftazidime is a long-established guideline option for anti-pseudomonal cover and is recommended in melioidosis and febrile neutropenia regimens.