Ceftizoxime

Uses and Administration

Ceftizoxime is a third-generation parenteral cephalosporin antibacterial used for the treatment of infections caused by susceptible Gram-positive and Gram-negative bacteria, including infections of the abdomen, bones and joints, CNS, skin and skin structures, genito-urinary and respiratory tracts, and gynaecological infections. For details of these infections and their treatment, see under Choice of Antibacterial, Refer to .

Ceftizoxime is given as the sodium salt by deep intramuscular injection, or intravenously as a slow injection over 3 to 5 minutes or as a continuous or intermittent infusion. If 2 g of ceftizoxime is injected intramuscularly the dose should be divided between sites.

Doses are expressed in terms of the equivalent amount of ceftizoxime; 1.06 g of ceftizoxime sodium is equivalent to about 1 g of ceftizoxime. It is usually given in an adult dose of 1 to 2 g every 8 to 12 hours. In severe infections 2 to 4 g may be given intravenously every 8 hours; doses up to 2 g every 4 hours have been given in life-threatening infections.

For the treatment of uncomplicated urinary-tract infections, a dose of 500 mg every 12 hours is used. A single intramuscular dose of 1 g has been given in uncomplicated gonorrhoea.

The dose of ceftizoxime may need to be reduced in patients with renal impairment, see Refer to .

(last reviewed 2010-08-20; last modified 2016-12-19)

References.

(last reviewed 2010-08-20; last modified 2004-03-25)

References

1. Richards DM, Heel RC. Ceftizoxime: a review of its antibacterial activity, pharmacokinetic properties and therapeutic use.Drugs. 1985; 29: 281–329. PubMed

Administration in renal impairment

Parenteral doses of ceftizoxime should be modified in renal impairment; after a loading dose of 0.5 to 1 g, the maintenance dosage should be adjusted according to creatinine clearance (CC) and the severity of the infection:

CC 50 to 79 mL/minute: 0.5 to 1.5 g every 8 hours

CC 5 to 49 mL/minute: 0.25 to 1 g every 12 hours

CC less than 5 mL/minute: 250 to 500 mg every 24 hours or 0.5 to 1 g every 48 hours, after dialysis.

(last reviewed 2010-08-20; last modified 2010-07-27)

Adverse Effects, Treatment and Precautions

Adverse Effects and Precautions

As for Cefotaxime Sodium, Refer to .

(last reviewed 2010-08-20; last modified 2004-03-25)

Sodium content

Each g of ceftizoxime sodium contains about 2.5 mmol of sodium.

(last reviewed 2010-08-20; last modified 2003-11-21)

Interactions

Probenecid reduces the renal clearance of ceftizoxime.

(last reviewed 2010-08-20; last modified 2004-03-25)

Mechanism of Action

Antimicrobial Action

As for Cefotaxime Sodium, Refer to , although ceftizoxime has no active metabolite.

(last reviewed 2010-08-20; last modified 2004-03-25)

Pharmacokinetics

After intramuscular injection of 0.5 and 1 g of ceftizoxime, mean peak plasma concentrations of about 14 and 39 micrograms/mL respectively have been reported after 1 hour. The plasma half-life of ceftizoxime is about 1.7 hours and is prolonged in neonates and in renal impairment. Ceftizoxime is 30% bound to plasma proteins.

Ceftizoxime is widely distributed in body tissues and fluids; therapeutic concentrations occur in the CSF when the meninges are inflamed. It crosses the placenta and low concentrations have been detected in breast milk.

Nearly all of a dose is excreted unchanged in the urine within 24 hours of dosage, thus achieving high urinary concentrations. Ceftizoxime is excreted by tubular secretion as well as glomerular filtration and giving it with probenecid results in higher and more prolonged plasma concentrations. Some ceftizoxime is removed by haemodialysis.

(last reviewed 2010-08-20; last modified 2009-09-04)

Neonates

References.

(last reviewed 2010-08-20; last modified 2004-03-25)

References

1. Fujii R. Investigation of half-life and clinical effects of ceftizoxime in premature and newborn infants.Drug Invest. 1990; 2: 143–9.

2. Reed MD, et al.. Ceftizoxime disposition in neonates and infants during the first six months of life.DICP Ann Pharmacother. 1991; 25: 344–7. PubMed

Preparations: Single-Ingredient

The following preparations list represents a compilation of all available salt forms or related substances for this drug product.

The symbol ¤ denotes a preparation which is discontinued or no longer actively marketed.

ARGENTINA: Ceftix¤; Ceftizon¤;AUSTRIA: Cefizox¤;CANADA: Cefizox¤;CHINA: Dalijing (达力净); Daliqing (达力清); Epocelin (益保世灵); Zhuobisha (卓必沙);CZECH REPUBLIC: Cefizox¤;FINLAND: Epocelin¤;FRANCE: Cefizox¤;GERMANY: Ceftix¤;INDIA: Cefizox; Eldcef; Epocelin;INDONESIA: Cefim; Cefizox; Ceftien; Ceftiz; Chromagen; Tizos;IRELAND: Cefizox¤;ISRAEL: Tefizox¤;ITALY: Eposerin;JAPAN: Epocelin;MEXICO: Cefizox¤; Ultracef¤;NETHERLANDS: Cefizox¤;PHILIPPINES: Tergecin¤; Unizox; Zoxim;PORTUGAL: Cefizox;RUSSIAN FEDERATION: Cefzoxime (Цефзоксим);SPAIN: Cefizox¤; Epocelin¤;THAILAND: Epocelin¤;TURKEY: Cefizox;UNITED KINGDOM: Cefizox¤;UNITED STATES: Cefizox¤;

Preparations: Pharmacopoeial

The following preparations list represents a compilation of all available salt forms or related substances for this drug product.

USP 42: Ceftizoxime for Injection; Ceftizoxime Injection;

Therapeutic Use

• Antibacterials

Last Updated 1/21/20