Ceftazidime

Cystic fibrosis: IV: Manufacturer’s labeling: 90 to 150 mg/kg/day every 8 hours (maximum: 6 g daily) Alternative recommendations: Intermittent IV infusion: 200 to 400 mg/kg/day divided every 6 to 8 hours (maximum: 8 to 12 g daily); or by continuous IV infusion: 100 to 200 mg/kg/day (maximum: 12 g daily) (Zobell, 2013) Empiric therapy in immunocompromised patients: IV: 2 g every 8 hours Endophthalmitis, bacterial (off-label use): Intravitreal: 2 to 2.25 mg/0.1 mL NS in combination with vancomycin (Jackson, 2003; Roth, 1997) Intra-abdominal infection, severe (in combination with metronidazole): IV: 2 g every 8 hours for 4 to 7 days (provided source controlled). Not recommended for hospital-acquired intra-abdominal infections (IAI) associated with multidrug-resistant gram negative organisms or in mild-to-moderate community-acquired IAIs due to risk of toxicity and the development of resistant organisms (Solomkin, 2010). Melioidosis (off-label use): IV: Note: Switching to meropenem therapy is indicated if patient condition worsens (eg, organ failure, new infection focus development, repeat blood cultures remained positive). Oral eradication therapy is recommended after the intensive (acute) phase treatment is complete (Lipsitz, 2012). Severe, acute phase: 50 mg/kg/dose every 8 hours (maximum dose: 2 g) or 2 g for one dose, followed by 6 g daily by continuous infusion for ≥10 days with or without TMP/SMX (Lipsitz, 2012). Non-cystic fibrosis bronchiectasis (off-label use/route): Inhalation for nebulization: 250 to 1,000 mg every 12 hours or 500 mg every 6 hours for up to 12 months (Le 2010, Orriols 1999) Osteomyelitis, native vertebral due to P. aeruginosa (alternative therapy) (off-label dose): IV: 2 g every 8 hours for 6 weeks Note: Double coverage may be considered (ie, ceftazidime plus an aminoglycoside or ciprofloxacin) (IDSA [Berbari 2015]) Peritonitis (CAPD) (off-label route; Li, 2010): Intraperitoneal: Intermittent: 1 to 1.5 g every 24 hours per exchange in the long dwell (≥6 hours) Continuous (per liter exchange): Loading dose: 500 mg; maintenance dose: 125 mg. Note: If patient has residual renal function (eg, >100 mL/day urine output), empirically increase each dose by 25%. Pneumonia: Uncomplicated: IM, IV: 500 mg to 1 g every 8 hours Hospital-acquired or ventilator-associated (off-label): IV: 2 g every 8 hours for 7 days; may consider shorter or longer duration depending on rate of clinical improvement. When used as empiric therapy, use in combination with an agent active against S. aureus with or without an additional antipseudomonal agent (dependent on patient and institution-specific risk factors) (Kalil 2016) Prosthetic joint infection, Pseudomonas aeruginosa (alternative to cefepime or meropenem): IV: 2 g every 8 hours for 4 to 6 weeks (consider addition of an aminoglycoside) (Osmon, 2013) Skin and soft tissue infections: IV, IM: 500 mg to 1 g every 8 hours Severe infections, including meningitis, CNS infection, osteomyelitis, gynecolog