Ceftizoxime

J01D - Other beta-lactam antibacterials ATC J01DD07 Small molecule approved 1983 Parenteral Natural product

🧬 Cross-allergy: Cephalosporins

JFDA label: Cefizox 500 IM Injection

Indications

Approved

Bacterial Infections — bacterial disease

Class profile

gramStatus	Both
spectrumBreadth	Broad
atypicalCoverage	No
isBactericidal	1
moaCategory	Cell wall synthesis inhibitor (beta-lactam, 3rd generation cephalosporin)
pdIndex	Time-dependent
postAntibioticEffect	None
mrsaCoverage	0
resistanceMechanisms	ESBL production,AmpC beta-lactamase

Pregnancy & Lactation

Lactation

Probably Compatible Hale L2

Limited information indicates that ceftizoxime produces low levels in milk that are not expected to cause adverse

Monitoring

Efficacy	Culture and susceptibility testing; clinical resolution (temperature, WBC, CRP, procalcitonin)
Toxicity	Renal function (dose adjustment in renal impairment); hepatic function for hepatically cleared agents; signs of C. difficile infection (diarrhoea)
Clinical pearl	Culture results guide de-escalation to narrower-spectrum therapy. Review antibiotic appropriateness at 48–72 h (antimicrobial stewardship).
Counseling	Complete the full course. Report persistent diarrhoea, rash, or lack of improvement after 48–72 h.

Chemistry & Properties

Formula	C13H13N5O5S2
Molecular weight	383.41 g/mol
IUPAC name	(6R,7R)-7-[[(2Z)-2-(2-amino-1,3-thiazol-4-yl)-2-methoxyiminoacetyl]amino]-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid
CAS	68401-81-0
PubChem CID	6533629
InChIKey	`NNULBSISHYWZJU-LLKWHZGFSA-N`
logP	-0.56 (XLogP 0.0)
Polar surface area	147.21 Å²
H-bond acceptors / donors	9 / 3
Drug-likeness (QED)	0.35
Lipinski violations	0

SMILES

CO/N=C(\C(=O)N[C@@H]1C(=O)N2C(C(=O)O)=CCS[C@H]12)c1csc(N)n1

Biology & Pharmacokinetics

Pharmacokinetics

BBB penetrant	No

Enzyme interactions

Enzyme	Role	Detail
CYP2B6	Inhibitor	—
CYP2C8	Inhibitor	—
CYP2C9	Substrate	—

Transporters

BCRP (Inhibitor)BSEP (Inhibitor)MRP1 (Inhibitor)OAT1 (Inhibitor)OAT3 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)P-gp (Inhibitor)MRP4 (Substrate)OAT1 (Substrate)OAT3 (Substrate)P-gp (Substrate)PEPT1 (Substrate)

Drug–drug interactions (12, DDInter)

Interacting drug	Severity	Management
Amikacin	moderate
Amikacin (liposome)	moderate
Chloramphenicol	moderate
Ethinylestradiol	moderate
Gentamicin	moderate
Kanamycin	moderate
Mycophenolic acid	moderate
Neomycin	moderate
Pemetrexed	moderate
Picosulfuric acid	moderate
Streptomycin	moderate
Warfarin	moderate

Registered Products (12)

Brand	Form / strength	Pack	Agent	Citizen (JOD)
Cefizox 500 IM Injection	Powder for Injection (as sodium) 500 mg	1 vial pack varies	Hikma Pharmaceuticals Co.Ltd/Jordan	5.080
Cefizox 500 IV Injection	Powder for Injection (as sodium) 500 mg	1 vial pack varies	Hikma Pharmaceuticals Co.Ltd/Jordan	5.080
Anabact IM	Vial 1 g, 5 ml	1 vial	pharma international	6.400
Anabact IV	Ampoule 1 g	1 amp pack varies	pharma international	6.400
Anabact 1g IM/IV Powder For Inj	Powder for Injection 1 g	1 vial pack varies	Pharma International Company/ Jordan	6.400
Cefizox 1000mg IM Injection	Powder for Injection (as sodium)1000 mg	1 amp pack varies	Hikma Pharmaceuticals Co.Ltd/Jordan	6.800
Cefizox 1000mg IV Injection	Powder for Injection (as sodium)1000 mg	1 vial pack varies	Hikma Pharmaceuticals Co.Ltd/Jordan	7.650
Anabact 2 g IM/IV	Vial 2 g	1 vial	Pharma International Company/ Jordan	11.010
Cefizox 500 IM Injection	Powder for Injection (as sodium) 500 mg	10 vial pack varies	Hikma Pharmaceuticals Co.Ltd/Jordan	45.720
Cefizox 500 IV Injection	Powder for Injection (as sodium) 500 mg	10 vial pack varies	Hikma Pharmaceuticals Co.Ltd/Jordan	45.720
Cefizox 1000mg IM Injection	Powder for Injection (as sodium)1000 mg	10 vial pack varies	Hikma Pharmaceuticals Co.Ltd/Jordan	61.200
Cefizox 1000mg IV Injection	Powder for Injection (as sodium)1000 mg	10 vial pack varies	Hikma Pharmaceuticals Co.Ltd/Jordan	68.850