Ceftazidime

Identification

Summary

Ceftazidime is an injected broad-spectrum third-generation cephalosporin beta-lactam antibiotic used to treat or prevent a variety of bacterial infections, including pneumonia, gynecological infections, bone and joint infections, and septicemia, among others.

Brand Names

Avycaz, Fortaz, Tazicef, Zavicefta

Generic Name

Ceftazidime

DrugBank Accession Number

DB00438

Background

Bacteria possess a cell wall comprising a glycopeptide polymer commonly known as peptidoglycan, which is synthesized and remodelled through the action of a family of enzymes known as "penicillin-binding proteins" (PBPs).¹ β-lactam antibiotics, including cephalosporins, are PBP inhibitors that, through inhibition of essential PBPs, result in impaired cell wall homeostasis, loss of cell integrity, and ultimately bacterial cell death.^1,2,3 Ceftazidime is a third-generation cephalosporin with broad-spectrum antibacterial activity, including against some treatment-resistant bacteria such as Pseudomonas aeruginosa.¹²

Ceftazidime was approved by the FDA on July 19, 1985, and is currently available either alone or in combination with the non-β-lactam β-lactamase inhibitor avibactam to treat a variety of bacterial infections.^12,13

Type

Small Molecule

Groups

Approved

Structure

3D

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MOLSDF3D-SDFPDBSMILESInChI

Similar Structures

Structure for Ceftazidime (DB00438)

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Weight

Average: 546.576
Monoisotopic: 546.099138468

Chemical Formula

C₂₂H₂₂N₆O₇S₂

Synonyms

• CAZ
• Ceftazidim
• Ceftazidima
• Ceftazidime
• Ceftazidime anhydrous
• Ceftazidimum

External IDs

• GR 20263

Pharmacology

Indication

Ceftazidime is indicated for the treatment of lower respiratory tract infections, skin and skin structure infections, urinary tract infections, bacterial septicemia, bone and joint infections, gynecologic infections, intra-abdominal infections (including peritonitis), and central nervous system infections (including meningitis) caused by susceptible bacteria.¹²

Ceftazidime is indicated in combination with avibactam to treat infections caused by susceptible Gram-negative organisms, including complicated intra-abdominal infections (cIAI), in conjunction with metronidazole, and complicated urinary tract infections (cUTI), including pyelonephritis, in patients aged three months and older. This combination is also indicated to treat hospital-acquired and ventilator-associated bacterial pneumonia (HABP/VABP) in patients aged 18 years and older.¹³

In all cases, to mitigate the risk of bacterial resistance and preserve clinical efficacy, ceftazidime should only be used for infections that are confirmed or strongly suspected to be caused by susceptible bacterial strains.^12,13

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Associated Conditions

• Bacteremia
• Bacterial Infections
• Bloodstream Infections
• Bone and Joint Infections
• Bronchopulmonary Infection
• Central Nervous System Infections
• Complicated Intra Abdominal Infections
• Complicated Skin and Soft Tissue Infection
• Complicated Urinary Tract Infection
• Complicated Urinary Tract Infections caused by susceptible Gram-negative microorganisms
• Fever caused by susceptible bacteria
• Gynaecological infection
• Intra Abdominal Infections
• Lower Respiratory Tract Infection (LRTI)
• Meningitis, Bacterial
• Nosocomial Pneumonia
• Peritoneal Dialysis Associated Peritonitis
• Skin and skin structure infections
• Urinary Tract Infection
• Ventilator-associated Bacterial Pneumonia caused by susceptible Gram-negative microorganisms
• Chronic suppurative Otitis media
• Hospital-acquired bacterial pneumonia caused by susceptible Gram-negative microorganisms
• Malignant Otitis Externa
• Susceptible Intra-Abdominal Infection caused by susceptible Gram-negative microorganism

Contraindications & Blackbox Warnings

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Pharmacodynamics

Ceftazidime is a semisynthetic, broad-spectrum, third-generation cephalosporin antibiotic that is bactericidal through inhibition of enzymes responsible for cell-wall synthesis, primarily penicillin-binding protein 3 (PBP3).¹² Among cephalosporins, ceftazidime is notable for its resistance to numerous β-lactamases and its broad spectrum of activity against Gram-negative bacteria, including Pseudomonas aeruginosa.⁴ However, it is less active than first- and second-generation cephalosporins against Staphylococcus aureus and other Gram-positive bacteria and also has low activity against anaerobes.^4,9 Ceftazidime has confirmed activity against clinically relevant Gram-negative bacteria including Citrobacter spp., Enterobacter spp., Klebsiella spp., Proteus spp., Serratia spp., _Escherichia coli, Haemophilus influenzae, Neisseria meningitidis, Pseudomonas aeruginosa, and some Gram-positive bacteria including Staphylococcus spp. and Streptococcus spp. There are also in vitro data for ceftazidime efficacy against a wide variety of other bacteria, such as Acinetobacter baumannii and Neisseria gonorrhoeae, but no clear clinical studies to support the use of ceftazidime for infections caused by these bacteria.¹²

Although β-lactam antibiotics like ceftazidime are generally well tolerated, there remains a risk of serious acute hypersensitivity reactions, which is higher in patients with a known allergy to ceftazidime or any other β-lactam antibiotic. As with all antibiotics, ceftazidime may result in the overgrowth of non-susceptible organisms and potentially serious effects including Clostridium difficile-associated diarrhea (CDAD); CDAD should be considered in patients who develop diarrhea and, in confirmed cases, supportive care initiated immediately. Ceftazidime is primarily renally excreted such that high and prolonged serum concentrations can occur in patients with renal insufficiency, leading to seizures, nonconvulsive status epilepticus (NCSE), encephalopathy, coma, asterixis, neuromuscular excitability, and myoclonia. Treatment may lead to the development or induction of resistance with a risk of treatment failure. Periodic susceptibility testing should be considered, and monotherapy failure may necessitate the addition of another antibiotic such as an aminoglycoside. Cephalosporin use may decrease prothrombin activity, which may be improved by exogenous vitamin K. Inadvertent intra-arterial administration of ceftazidime may result in distal necrosis.¹²

Mechanism of action

The bacterial cell wall, which is located at the periphery of Gram-positive bacteria and within the periplasm of Gram-negative bacteria, comprises a glycopeptide polymer synthesized through cross-linking of glycans to peptide stems on alternating saccharides, which is known commonly as peptidoglycan.¹ Cell wall formation, recycling, and remodelling require numerous enzymes, including a family of enzymes with similar active site character despite distinct and sometimes overlapping roles as carboxypeptidases, endopeptidases, transpeptidases, and transglycosylases, known as "penicillin-binding proteins" (PBPs). The number of PBPs differs between bacteria, in which some are considered essential and others redundant. In general, inhibition of one or more essential PBPs results in impaired cell wall homeostasis, loss of cell integrity, and is ultimately bactericidal.^1,2,3

Ceftazidime is a semisynthetic third-generation cephalosporin with broad activity against numerous Gram-negative and some Gram-positive bacteria.¹² Like other β-lactam antibiotics, ceftazidime exhibits its bactericidal effect primarily through direct inhibition of specific PBPs in susceptible bacteria.⁴ In vitro experiments in Gram-negative bacteria such as Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae suggest that ceftazidime primarily binds to PBP3, with weaker binding to PBP1a/1b and PBP2 as well; although binding to other PBPs, such as PBP4, is detectable, the concentrations required are much greater than those achieved clinically.^4,5,6,7,8 Similarly, ceftazidime showed binding to Staphylococcus aureus PBP 1, 2, and 3 with a much lower affinity for PBP4.⁵ Recent data for Mycobacterium abcessus suggest that ceftazidime can inhibit PonA1, PonA2, and PbpA at intermediate concentrations.³

Target	Actions	Organism
APeptidoglycan synthase FtsI	inhibitor	Escherichia coli (strain K12)
APenicillin-binding protein 1A	inhibitor	Escherichia coli (strain K12)
APenicillin-binding protein 1B	inhibitor	Escherichia coli (strain K12)
APenicillin-binding protein 2	inhibitor	Escherichia coli (strain K12)

Absorption

Ceftazidime administered intravenously in healthy males produced mean C_max values of between 42 and 170 μg/mL for doses between 500 mg and 2 g, and are reached immediately following the end of the infusion period.¹² The C_max for 1 g of ceftazidime administered intramuscularly is attained approximately one hour following injection and is between 37 and 43 mg/L.⁴ Following intramuscular administration of 500 mg and 1 g of ceftazidime, the serum concentration remained above 4 μg/mL for six and eight hours, respectively.¹²

Ceftazidime C_max and AUC show linear proportionality to the dose over the therapeutic range.^4,12 In individuals with normal renal function, ceftazidime given intravenously every eight hours for 10 days as either 1 or 2 g doses showed no accumulation.¹²

Volume of distribution

Ceftazidime has a volume of distribution of 15-20 L.⁴

Protein binding

Ceftazidime plasma protein binding ranges from 5-22.8% (typically less than 10%) and is independent of concentration.^4,12 Ceftazidime has been shown to bind human serum albumin.^10,11

Metabolism

Ceftazidime is not appreciably metabolized.⁴

Route of elimination

Approximately 80% to 90% of an intramuscular or intravenous dose of ceftazidime is excreted unchanged by the kidneys over a 24-hour period. When administered intravenously, 50% of the dose appears in the urine within two hours, with another 32% of the dose appearing by eight hours post-administration.¹²

Half-life

Ceftazidime has an elimination half-life of 1.5-2.8 hours in healthy subjects.^4,12 As ceftazidime is primarily renally excreted, its half-life is significantly prolonged in patients with renal impairment.¹² In patients with creatinine clearance < 12 mL/min, the half-life is prolonged to between 14 and 30 hours.⁴

Clearance

The mean renal clearance of ceftazidime in healthy subjects ranges from 72 to 141 mL/min while the calculated plasma clearance is approximately 115 mL/min.^4,12

Adverse Effects

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Toxicity

Ceftazidime overdosage has occurred in patients with renal failure. Reactions included seizure activity, encephalopathy, asterixis, neuromuscular excitability, and coma. Patients who receive an acute overdosage should be carefully observed and given supportive treatment. In the presence of renal insufficiency, hemodialysis or peritoneal dialysis may aid in the removal of ceftazidime from the body.¹²

Pathways

Not Available

Pharmacogenomic Effects/ADRs

Not Available

Interactions

Drug Interactions

This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.

• Approved
• Vet approved
• Nutraceutical
• Illicit
• Withdrawn
• Investigational
• Experimental
• All Drugs

Drug	Interaction
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Abacavir	Ceftazidime may decrease the excretion rate of Abacavir which could result in a higher serum level.
Abciximab	The therapeutic efficacy of Abciximab can be decreased when used in combination with Ceftazidime.
Aceclofenac	The risk or severity of nephrotoxicity can be increased when Ceftazidime is combined with Aceclofenac.
Acemetacin	The risk or severity of nephrotoxicity can be increased when Acemetacin is combined with Ceftazidime.
Acenocoumarol	The risk or severity of bleeding can be increased when Ceftazidime is combined with Acenocoumarol.
Acetaminophen	Ceftazidime may decrease the excretion rate of Acetaminophen which could result in a higher serum level.
Acetazolamide	Acetazolamide may increase the excretion rate of Ceftazidime which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acid	The risk or severity of nephrotoxicity can be increased when Ceftazidime is combined with Acetylsalicylic acid.
Aclidinium	Ceftazidime may decrease the excretion rate of Aclidinium which could result in a higher serum level.
Acrivastine	Ceftazidime may decrease the excretion rate of Acrivastine which could result in a higher serum level.

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Food Interactions

No interactions found.

Products

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Product Ingredients

Ingredient	UNII	CAS	InChI Key
Ceftazidime pentahydrate	9M416Z9QNR	78439-06-2	NMVPEQXCMGEDNH-TZVUEUGBSA-N
Ceftazidime sodium	CMC30V039K	73547-61-2	JEEWDSDYUSEQML-ROMZVAKDSA-M

International/Other Brands

Cefzim (Pharco B International) / Ceptaz / Fortum (GlaxoSmithKline) / Tazidime / Veltadim (Novell)

Brand Name Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End	Region	Image
Ceftazidime and Dextrose	Injection, solution	2 g/50mL	Intravenous	B. Braun Medical Inc.	2011-06-13	Not applicable
Ceftazidime and Dextrose	Injection, solution	1 g/50mL	Intravenous	B. Braun Medical Inc.	2011-06-13	Not applicable
Ceftazidime for Injection BP	Powder, for solution	6 g / vial	Intravenous	Sterimax Inc	2015-06-08	Not applicable
Ceftazidime for Injection BP	Powder, for solution	2 g / vial	Intravenous	Sterimax Inc	2015-05-29	Not applicable
Ceftazidime for Injection BP	Powder, for solution	1 g / vial	Intramuscular; Intravenous	Sterimax Inc	2015-05-28	Not applicable
Ceftazidime for Injection, BP	Powder, for solution	3 g / vial	Intravenous	Sterimax Inc	2015-06-08	Not applicable
Ceftazidime for Injection, USP	Powder, for solution	6 g / vial	Intravenous	Fresenius Kabi	1991-12-31	Not applicable
Ceftazidime for Injection, USP	Powder, for solution	2 g / vial	Intravenous	Fresenius Kabi	1991-12-31	Not applicable
Ceftazidime for Injection, USP	Powder, for solution	1 g / vial	Intramuscular; Intravenous	Fresenius Kabi	1991-12-31	Not applicable
Ceptaz Inj 10gm/vial	Powder, for solution	10 g / vial	Intravenous	Glaxo Canada Inc	1993-12-31	2001-11-07

Generic Prescription Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End	Region	Image
Ceftazidime	Injection, powder, for solution	1 g/20mL	Intramuscular; Intravenous	WG Critical Care, LLC	2013-01-31	Not applicable
Ceftazidime	Injection, powder, for solution	200 mg/1mL	Intravenous	Sandoz	2008-05-15	Not applicable
Ceftazidime	Injection, powder, for solution	1 g/1	Intramuscular; Intravenous	Pfizer Laboratories, Division of Pfizer Inc	2010-05-28	2012-06-30
Ceftazidime	Injection, powder, for solution	1 g/1	Intramuscular; Intravenous	Aurobindo Pharma	2010-05-28	2012-06-30
Ceftazidime	Injection, powder, for solution	1 g/1	Intramuscular; Intravenous	Sagent Pharmaceuticals	2015-07-01	Not applicable
Ceftazidime	Injection, powder, for solution	2 g/1	Intravenous	Sandoz	2008-05-15	Not applicable
Ceftazidime	Injection, powder, for solution	6 g/100mL	Intravenous	WG Critical Care, LLC	2013-01-31	Not applicable
Ceftazidime	Injection, powder, for solution	200 mg/1mL	Intravenous	Aurobindo Pharma	2010-05-28	2012-10-31
Ceftazidime	Injection, powder, for solution	500 mg/1	Intramuscular; Intravenous	Pfizer Laboratories, Division of Pfizer Inc	2010-05-28	2012-06-30
Ceftazidime	Injection, powder, for solution	500 mg/1	Intramuscular; Intravenous	Aurobindo Pharma	2010-05-28	2012-06-30

Mixture Products

Name	Ingredients	Dosage	Route	Labeller	Marketing Start	Marketing End	Region	Image
Avycaz	Ceftazidime pentahydrate (2 g/1) + Avibactam sodium (0.5 g/1)	Powder, for solution	Intravenous	Allergan, Inc.	2014-12-26	Not applicable
Zavicefta	Ceftazidime pentahydrate (2000 mg) + Avibactam sodium (500 mg)	Injection, powder, for solution	Intravenous	Pfizer Ireland Pharmaceuticals	2016-09-08	Not applicable
ZAVİCEFTA 2 G/0.5 G İNFÜZYONLUK ÇÖZELTİ HAZIRLAMAK İÇİN TOZ, 10 ADET	Ceftazidime (2 g) + Avibactam (0.5 g)	Injection, powder, for solution		PFİZER PFE İLAÇLARI A.Ş.	2020-08-14	Not applicable
ซาวิเซฟตา	Ceftazidime (2 G/1VIAL) + Avibactam sodium (500 MG/1VIAL)			บริษัท ไฟเซอร์ (ประเทศไทย) จำกัด	2019-08-02	Not applicable

Categories

ATC Codes

J01DD02 — Ceftazidime

• J01DD — Third-generation cephalosporins
• J01D — OTHER BETA-LACTAM ANTIBACTERIALS
• J01 — ANTIBACTERIALS FOR SYSTEMIC USE
• J — ANTIINFECTIVES FOR SYSTEMIC USE

Drug Categories

• Amides
• Anti-Bacterial Agents
• Anti-Infective Agents
• Antibacterials for Systemic Use
• Antiinfectives for Systemic Use
• beta-Lactams
• Cephalosporins
• Drugs that are Mainly Renally Excreted
• Heterocyclic Compounds, Fused-Ring
• Lactams
• Nephrotoxic agents
• OAT1/SLC22A6 inhibitors
• Sulfur Compounds
• Thiazines
• Third-Generation Cephalosporins

Chemical TaxonomyProvided by Classyfire

Description

This compound belongs to the class of organic compounds known as cephalosporins. These are compounds containing a 1,2-thiazine fused to a 2-azetidinone to for a oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid moiety or a derivative thereof.

Kingdom

Organic compounds

Super Class

Organoheterocyclic compounds

Class

Lactams

Sub Class

Beta lactams

Direct Parent

Cephalosporins

Alternative Parents

N-acyl-alpha amino acids and derivatives / 2,4-disubstituted thiazoles / 1,3-thiazines / Pyridinium derivatives / 2-amino-1,3-thiazoles / Dicarboxylic acids and derivatives / Tertiary carboxylic acid amides / Heteroaromatic compounds / Secondary carboxylic acid amides / Amino acids / Azetidines / Carboxylic acid salts / Dialkylthioethers / Carboxylic acids / Thiohemiaminal derivatives / Azacyclic compounds / Organopnictogen compounds / Carbonyl compounds / Primary amines / Organic zwitterions / Hydrocarbon derivatives / Organic salts / Organic oxides

show 13 more

Substituents

1,3-thiazol-2-amine / 2,4-disubstituted 1,3-thiazole / Alpha-amino acid or derivatives / Amine / Amino acid / Amino acid or derivatives / Aromatic heteropolycyclic compound / Azacycle / Azetidine / Azole / Carbonyl group / Carboxamide group / Carboxylic acid / Carboxylic acid derivative / Carboxylic acid salt / Cephalosporin / Dialkylthioether / Dicarboxylic acid or derivatives / Hemithioaminal / Heteroaromatic compound / Hydrocarbon derivative / Meta-thiazine / N-acyl-alpha amino acid or derivatives / Organic nitrogen compound / Organic oxide / Organic oxygen compound / Organic salt / Organic zwitterion / Organonitrogen compound / Organooxygen compound / Organopnictogen compound / Primary amine / Pyridine / Pyridinium / Secondary carboxylic acid amide / Tertiary carboxylic acid amide / Thiazole / Thioether

show 28 more

Molecular Framework

Aromatic heteropolycyclic compounds

External Descriptors

cephalosporin, oxime O-ether (CHEBI:3508)

Affected organisms

• Enteric bacteria and other eubacteria

Chemical Identifiers

UNII

DZR1ENT301

CAS number

72558-82-8

InChI Key

ORFOPKXBNMVMKC-DWVKKRMSSA-N

InChI

InChI=1S/C22H22N6O7S2/c1-22(2,20(33)34)35-26-13(12-10-37-21(23)24-12)16(29)25-14-17(30)28-15(19(31)32)11(9-36-18(14)28)8-27-6-4-3-5-7-27/h3-7,10,14,18H,8-9H2,1-2H3,(H4-,23,24,25,29,31,32,33,34)/b26-13-/t14-,18-/m1/s1

IUPAC Name

1-{[(6R,7R)-7-[(2Z)-2-(2-amino-1,3-thiazol-4-yl)-2-[(1-carboxy-1-methylethoxy)imino]acetamido]-2-carboxylato-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-en-3-yl]methyl}pyridin-1-ium

SMILES

[O-]C(=O)C1=C(CS[C@]2([H])[C@H](NC(=O)C(=N/OC(C)(C)C(O)=O)\C3=CSC(N)=N3)C(=O)N12)C[N+]1=CC=CC=C1

References

Synthesis Reference

Ronald C. Browning, Melvin G. Pleiss, Jr., "Crystallization process for ceftazidime derivative." U.S. Patent US4659813, issued May, 1982.

US4659813

General References

1. Fisher JF, Mobashery S: Constructing and deconstructing the bacterial cell wall. Protein Sci. 2020 Mar;29(3):629-646. doi: 10.1002/pro.3737. Epub 2019 Nov 20. [Article]
2. Bush K, Bradford PA: beta-Lactams and beta-Lactamase Inhibitors: An Overview. Cold Spring Harb Perspect Med. 2016 Aug 1;6(8). pii: cshperspect.a025247. doi: 10.1101/cshperspect.a025247. [Article]
3. Sayed ARM, Shah NR, Basso KB, Kamat M, Jiao Y, Moya B, Sutaria DS, Lang Y, Tao X, Liu W, Shin E, Zhou J, Werkman C, Louie A, Drusano GL, Bulitta JB: First Penicillin-Binding Protein Occupancy Patterns for 15 beta-Lactams and beta-Lactamase Inhibitors in Mycobacterium abscessus. Antimicrob Agents Chemother. 2020 Dec 16;65(1). pii: AAC.01956-20. doi: 10.1128/AAC.01956-20. Print 2020 Dec 16. [Article]
4. Richards DM, Brogden RN: Ceftazidime. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use. Drugs. 1985 Feb;29(2):105-61. doi: 10.2165/00003495-198529020-00002. [Article]
5. Hayes MV, Orr DC: Mode of action of ceftazidime: affinity for the penicillin-binding proteins of Escherichia coli K12, Pseudomonas aeruginosa and Staphylococcus aureus. J Antimicrob Chemother. 1983 Aug;12(2):119-26. [Article]
6. Davies TA, Shang W, Bush K, Flamm RK: Affinity of doripenem and comparators to penicillin-binding proteins in Escherichia coli and Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2008 Apr;52(4):1510-2. doi: 10.1128/AAC.01529-07. Epub 2008 Feb 4. [Article]
7. Penwell WF, Shapiro AB, Giacobbe RA, Gu RF, Gao N, Thresher J, McLaughlin RE, Huband MD, DeJonge BL, Ehmann DE, Miller AA: Molecular mechanisms of sulbactam antibacterial activity and resistance determinants in Acinetobacter baumannii. Antimicrob Agents Chemother. 2015 Mar;59(3):1680-9. doi: 10.1128/AAC.04808-14. Epub 2015 Jan 5. [Article]
8. Sutaria DS, Moya B, Green KB, Kim TH, Tao X, Jiao Y, Louie A, Drusano GL, Bulitta JB: First Penicillin-Binding Protein Occupancy Patterns of beta-Lactams and beta-Lactamase Inhibitors in Klebsiella pneumoniae. Antimicrob Agents Chemother. 2018 May 25;62(6). pii: AAC.00282-18. doi: 10.1128/AAC.00282-18. Print 2018 Jun. [Article]
9. Shirley M: Ceftazidime-Avibactam: A Review in the Treatment of Serious Gram-Negative Bacterial Infections. Drugs. 2018 Apr;78(6):675-692. doi: 10.1007/s40265-018-0902-x. [Article]
10. Nerli B, Romanini D, Pico G: Structural specificity requirements in the binding of beta lactam antibiotics to human serum albumin. Chem Biol Interact. 1997 May 2;104(2-3):179-202. [Article]
11. Siddiqi MK, Alam P, Chaturvedi SK, Nusrat S, Ajmal MR, Abdelhameed AS, Khan RH: Probing the interaction of cephalosporin antibiotic-ceftazidime with human serum albumin: A biophysical investigation. Int J Biol Macromol. 2017 Dec;105(Pt 1):292-299. doi: 10.1016/j.ijbiomac.2017.07.036. Epub 2017 Jul 8. [Article]
12. FDA Approved Drug Products: FORTAZ (ceftazidime) injection [Link]
13. FDA Approved Drug Products: AVYCAZ (ceftazidime and avibactam) injection [Link]
14. Cayman Chemical: ceftazidime MSDS [Link]

External Links

Human Metabolome Database

HMDB0014582

KEGG Drug

D07654

KEGG Compound

C06889

PubChem Compound

5481173

PubChem Substance

46506143

ChemSpider

4587145

BindingDB

50420259

RxNav

1545984

ChEBI

3508

ChEMBL

CHEMBL44354

Therapeutic Targets Database

DAP000433

PharmGKB

PA448861

RxList

RxList Drug Page

Drugs.com

Drugs.com Drug Page

Wikipedia

Ceftazidime

FDA label

Download (360 KB)

MSDS

Download (28 KB)

Clinical Trials

Clinical Trials

Phase	Status	Purpose	Conditions	Count
4	Completed	Other	Cystic Fibrosis (CF)	1
4	Completed	Prevention	Pancreatitis	1
4	Completed	Prevention	Peritoneal dialysis therapy	1
4	Completed	Treatment	Antibiotic Reaction / Febrile Neutropenia / Leukemias / Pediatric, Cancer	1
4	Completed	Treatment	Infection	1
4	Completed	Treatment	Peritoneal Dialysis Associated Peritonitis	1
4	Not Yet Recruiting	Treatment	Acute Pyelonephritis / Bacteremia / Intra Abdominal Infections / Nosocomial Pneumonia / Urinary Tract Infection / Ventilator-associated Bacterial Pneumonia	1
4	Not Yet Recruiting	Treatment	Febrile Neutropenia	1
4	Recruiting	Treatment	Nosocomial Pneumonia	1
4	Terminated	Treatment	Cystic Fibrosis (CF) / Pseudomonas Aeruginosa / Pulmonary Exacerbation	1

Pharmacoeconomics

Manufacturers

• Acs dobfar spa
• Aurobindo pharma ltd
• Wockhardt ltd
• Glaxosmithkline
• Hospira inc
• Eli lilly and co
• Baxter healthcare corp

Packagers

• Antibioticos Ltd.
• Aurobindo Pharma Ltd.
• Baxter International Inc.
• BMH Ltd.
• Cardinal Health
• GlaxoSmithKline Inc.
• Hospira Inc.
• Medisca Inc.
• Sagent Pharmaceuticals
• Sandoz
• Wockhardt Ltd.

Dosage Forms

Form	Route	Strength
Powder, for solution	Intravenous
Injection, powder, for solution	Parenteral
Injection, powder, for solution	Parenteral
Injection, powder, for solution	Intramuscular; Parenteral
Injection, powder, for solution	Intravenous; Parenteral
Powder, for solution
Injection, powder, for solution	Intramuscular; Intravenous
Injection, powder, for solution	Intramuscular; Intravenous	1 g/1
Injection, powder, for solution	Intramuscular; Intravenous	1 g/20mL
Injection, powder, for solution	Intramuscular; Intravenous	500 mg/1
Injection, powder, for solution	Intravenous	2 g/1
Injection, powder, for solution	Intravenous	2 g/20mL
Injection, powder, for solution	Intravenous	200 mg/1mL
Injection, powder, for solution	Intravenous	6 g/30mL
Injection, powder, for solution	Intravenous	6 g/100mL
Injection, solution	Intravenous	1 g/50mL
Injection, solution	Intravenous	2 g/50mL
Powder, for solution	Intravenous	3 g / vial
Injection
Injection, powder, for solution
Powder, for solution	Intravenous	10 g / vial
Injection, powder, for solution	Intramuscular; Intravenous	100 mg/1mL
Injection, powder, for solution	Intramuscular; Intravenous	111 mg/1mL
Injection, powder, for solution	Intramuscular; Intravenous	170 mg/1mL
Injection, powder, for solution	Intramuscular; Intravenous	20 mg/1mL
Injection, powder, for solution	Intramuscular; Intravenous	200 mg/1mL
Injection, powder, for solution	Intramuscular; Intravenous	56 mg/1mL
Injection, powder, lyophilized, for solution	Intramuscular; Intravenous	1 g/1
Injection, powder, lyophilized, for solution	Intramuscular; Intravenous	2 g/1
Injection, solution	Intravenous	20 mg/1mL
Injection, solution	Intravenous	40 mg/1mL
Powder, for solution	Intramuscular; Intravenous	1 g / vial
Powder, for solution	Intravenous	2 g / vial
Powder, for solution	Intravenous	6 g / vial
Powder, for solution	Intramuscular; Intravenous	500 mg / vial
Injection	Intramuscular; Intravenous
Injection, powder, for solution	Intramuscular; Intravenous	1 g
Powder	Intramuscular
Powder	Intravenous
Injection	Intravenous
Injection, powder, for solution	Intravenous
Injection, powder, for solution	Intravenous	1 g/1
Injection, powder, for solution	Intravenous	6 g/1
Powder, for solution	Intravenous	1 g / vial
Powder	Intramuscular; Intravenous	500 mg / vial
Injection, powder, for solution	Intramuscular
Powder, for solution	Parenteral
Injection, powder, for solution
Injection, powder, for solution	Intravenous
Injection, powder, for solution	Intravenous; Parenteral
Powder, for solution	Intravenous	0.5 g
Powder		500 mg/1vial

Prices

Unit description	Cost	Unit
Fortaz 6 g/vial	150.11USD	vial
Ceftazidime 6 gm vial	97.05USD	vial
Fortaz 6 gm vial	82.8USD	vial
Fortaz 2 g/vial	50.01USD	vial
Tazicef 6 gram vial	29.88USD	vial
Fortaz 2 gm add-vantage vial	28.93USD	vial
Fortaz 2 gm vial	28.45USD	vial
Fortaz 1 g/vial	25.44USD	vial
Ceftazidime 2 gm vial	19.97USD	vial
Fortaz 1 gm add-vantage vial	14.71USD	vial
Fortaz 1 gm vial	14.23USD	vial
Tazicef 2 gram vial	10.66USD	vial
Ceftazidime 1 gm vial	10.46USD	vial
Ceftazidime-sodium carb powder	6.27USD	g
Tazicef 1 gram vial	4.57USD	vial
Fortaz-iso-osmot 2 gm/50 ml	0.62USD	ml
Fortaz-iso-osmotic 1 gm/50 ml	0.34USD	ml

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.

Patents

Patent Number	Pediatric Extension	Approved	Expires (estimated)	Region
US7112592	No	2006-09-26	2022-02-24
US8178554	No	2012-05-15	2021-07-24
US7612087	No	2009-11-03	2026-11-12
US8471025	No	2013-06-25	2031-08-12
US8835455	No	2014-09-16	2030-10-08
US8969566	No	2015-03-03	2032-06-15
US9284314	No	2016-03-15	2032-06-15
US9695122	No	2017-07-04	2032-06-15

Properties

State

Solid

Experimental Properties

Property	Value	Source
melting point (°C)	103-113	O'Callaghan, C.H., Livermore, D.G.H. and Newall, C.E.; British Patent 2,025,398; January 23, 1980; assigned to Glaxo Group Ltd.
logP	-1.60	HANSCH,C ET AL. (1995)

Predicted Properties

Property	Value	Source
Water Solubility	0.00573 mg/mL	ALOGPS
logP	-1.2	ALOGPS
logP	-4.1	ChemAxon
logS	-5	ALOGPS
pKa (Strongest Acidic)	2.77	ChemAxon
pKa (Strongest Basic)	4.26	ChemAxon
Physiological Charge	-1	ChemAxon
Hydrogen Acceptor Count	10	ChemAxon
Hydrogen Donor Count	3	ChemAxon
Polar Surface Area	191.22 Å2	ChemAxon
Rotatable Bond Count	9	ChemAxon
Refractivity	143.88 m3·mol-1	ChemAxon
Polarizability	51.06 Å3	ChemAxon
Number of Rings	4	ChemAxon
Bioavailability	1	ChemAxon
Rule of Five	No	ChemAxon
Ghose Filter	No	ChemAxon
Veber's Rule	No	ChemAxon
MDDR-like Rule	Yes	ChemAxon

Predicted ADMET Features

Property	Value	Probability
Human Intestinal Absorption	-	0.8406
Blood Brain Barrier	-	0.9857
Caco-2 permeable	-	0.7235
P-glycoprotein substrate	Substrate	0.8593
P-glycoprotein inhibitor I	Non-inhibitor	0.8782
P-glycoprotein inhibitor II	Inhibitor	0.6684
Renal organic cation transporter	Non-inhibitor	0.8311
CYP450 2C9 substrate	Non-substrate	0.8404
CYP450 2D6 substrate	Non-substrate	0.8155
CYP450 3A4 substrate	Substrate	0.5897
CYP450 1A2 substrate	Non-inhibitor	0.8112
CYP450 2C9 inhibitor	Non-inhibitor	0.7396
CYP450 2D6 inhibitor	Non-inhibitor	0.8758
CYP450 2C19 inhibitor	Non-inhibitor	0.7009
CYP450 3A4 inhibitor	Non-inhibitor	0.8354
CYP450 inhibitory promiscuity	Low CYP Inhibitory Promiscuity	0.7222
Ames test	Non AMES toxic	0.7979
Carcinogenicity	Non-carcinogens	0.8252
Biodegradation	Not ready biodegradable	0.9951
Rat acute toxicity	1.6048 LD50, mol/kg	Not applicable
hERG inhibition (predictor I)	Weak inhibitor	0.9938
hERG inhibition (predictor II)	Non-inhibitor	0.659

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)

Not Available

Spectra

Spectrum	Spectrum Type	Splash Key
Predicted GC-MS Spectrum - GC-MS	Predicted GC-MS	Not Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)	Predicted LC-MS/MS	Not Available
LC-MS/MS Spectrum - LC-ESI-QFT , negative	LC-MS/MS	splash10-0udi-1900000000-35c537be0b49e8347500
LC-MS/MS Spectrum - LC-ESI-QFT , negative	LC-MS/MS	splash10-0udi-3900000000-f8108350d09aeabb208f
LC-MS/MS Spectrum - LC-ESI-QFT , negative	LC-MS/MS	splash10-0pb9-9600000000-3a117de626550cd6bd1e
LC-MS/MS Spectrum - LC-ESI-QFT , negative	LC-MS/MS	splash10-0a4i-9200000000-42d1f87964b083915995
LC-MS/MS Spectrum - LC-ESI-QFT , negative	LC-MS/MS	splash10-0a4i-9100000000-9b08b7904165504611b6
LC-MS/MS Spectrum - LC-ESI-QFT , positive	LC-MS/MS	splash10-014j-0115900000-d76de6ad1809c0528b8c
LC-MS/MS Spectrum - LC-ESI-QFT , positive	LC-MS/MS	splash10-0006-1910000000-cb7ea1c7b4b139a7336e
LC-MS/MS Spectrum - LC-ESI-QFT , positive	LC-MS/MS	splash10-01tl-3900000000-07fadc61e1b566ec14ba
LC-MS/MS Spectrum - LC-ESI-QFT , positive	LC-MS/MS	splash10-004i-5900000000-e92b85ec9fabd9a4c1fe
LC-MS/MS Spectrum - LC-ESI-QFT , positive	LC-MS/MS	splash10-004i-7900000000-548213f534e499ba783b

Targets

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Details1. Peptidoglycan synthase FtsI

Kind

Protein

Organism

Escherichia coli (strain K12)

Pharmacological action

Yes

Actions

Inhibitor

Curator comments

The above was chosen as a representative target protein in a representative bacterium, and does not encompass all proteins/bacteria affected by this agent.

General Function

Peptidoglycan glycosyltransferase activity

Specific Function

Essential cell division protein that is required for the synthesis of peptidoglycan at the division septum (PubMed:1103132, PubMed:9614966). Catalyzes the synthesis of cross-linked peptidoglycan fr...

Gene Name

ftsI

Uniprot ID

P0AD68

Uniprot Name

Peptidoglycan synthase FtsI

Molecular Weight

63876.925 Da

References

1. Hayes MV, Orr DC: Mode of action of ceftazidime: affinity for the penicillin-binding proteins of Escherichia coli K12, Pseudomonas aeruginosa and Staphylococcus aureus. J Antimicrob Chemother. 1983 Aug;12(2):119-26. [Article]
2. Richards DM, Brogden RN: Ceftazidime. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use. Drugs. 1985 Feb;29(2):105-61. doi: 10.2165/00003495-198529020-00002. [Article]
3. Davies TA, Shang W, Bush K, Flamm RK: Affinity of doripenem and comparators to penicillin-binding proteins in Escherichia coli and Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2008 Apr;52(4):1510-2. doi: 10.1128/AAC.01529-07. Epub 2008 Feb 4. [Article]
4. Penwell WF, Shapiro AB, Giacobbe RA, Gu RF, Gao N, Thresher J, McLaughlin RE, Huband MD, DeJonge BL, Ehmann DE, Miller AA: Molecular mechanisms of sulbactam antibacterial activity and resistance determinants in Acinetobacter baumannii. Antimicrob Agents Chemother. 2015 Mar;59(3):1680-9. doi: 10.1128/AAC.04808-14. Epub 2015 Jan 5. [Article]
5. Sutaria DS, Moya B, Green KB, Kim TH, Tao X, Jiao Y, Louie A, Drusano GL, Bulitta JB: First Penicillin-Binding Protein Occupancy Patterns of beta-Lactams and beta-Lactamase Inhibitors in Klebsiella pneumoniae. Antimicrob Agents Chemother. 2018 May 25;62(6). pii: AAC.00282-18. doi: 10.1128/AAC.00282-18. Print 2018 Jun. [Article]

Details2. Penicillin-binding protein 1A

Kind

Protein

Organism

Escherichia coli (strain K12)

Pharmacological action

Yes

Actions

Inhibitor

Curator comments

The above was chosen as a representative target protein in a representative bacterium, and does not encompass all proteins/bacteria affected by this agent.

General Function

Serine-type d-ala-d-ala carboxypeptidase activity

Specific Function

Cell wall formation. Synthesis of cross-linked peptidoglycan from the lipid intermediates. The enzyme has a penicillin-insensitive transglycosylase N-terminal domain (formation of linear glycan str...

Gene Name

mrcA

Uniprot ID

P02918

Uniprot Name

Penicillin-binding protein 1A

Molecular Weight

93635.545 Da

References

1. Hayes MV, Orr DC: Mode of action of ceftazidime: affinity for the penicillin-binding proteins of Escherichia coli K12, Pseudomonas aeruginosa and Staphylococcus aureus. J Antimicrob Chemother. 1983 Aug;12(2):119-26. [Article]
2. Richards DM, Brogden RN: Ceftazidime. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use. Drugs. 1985 Feb;29(2):105-61. doi: 10.2165/00003495-198529020-00002. [Article]
3. Davies TA, Shang W, Bush K, Flamm RK: Affinity of doripenem and comparators to penicillin-binding proteins in Escherichia coli and Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2008 Apr;52(4):1510-2. doi: 10.1128/AAC.01529-07. Epub 2008 Feb 4. [Article]
4. Penwell WF, Shapiro AB, Giacobbe RA, Gu RF, Gao N, Thresher J, McLaughlin RE, Huband MD, DeJonge BL, Ehmann DE, Miller AA: Molecular mechanisms of sulbactam antibacterial activity and resistance determinants in Acinetobacter baumannii. Antimicrob Agents Chemother. 2015 Mar;59(3):1680-9. doi: 10.1128/AAC.04808-14. Epub 2015 Jan 5. [Article]
5. Sutaria DS, Moya B, Green KB, Kim TH, Tao X, Jiao Y, Louie A, Drusano GL, Bulitta JB: First Penicillin-Binding Protein Occupancy Patterns of beta-Lactams and beta-Lactamase Inhibitors in Klebsiella pneumoniae. Antimicrob Agents Chemother. 2018 May 25;62(6). pii: AAC.00282-18. doi: 10.1128/AAC.00282-18. Print 2018 Jun. [Article]

Details3. Penicillin-binding protein 1B

Kind

Protein

Organism

Escherichia coli (strain K12)

Pharmacological action

Yes

Actions

Inhibitor

Curator comments

The above was chosen as a representative target protein in a representative bacterium, and does not encompass all proteins/bacteria affected by this agent.

General Function

Serine-type d-ala-d-ala carboxypeptidase activity

Specific Function

Cell wall formation. Synthesis of cross-linked peptidoglycan from the lipid intermediates. The enzyme has a penicillin-insensitive transglycosylase N-terminal domain (formation of linear glycan str...

Gene Name

mrcB

Uniprot ID

P02919

Uniprot Name

Penicillin-binding protein 1B

Molecular Weight

94291.875 Da

References

1. Hayes MV, Orr DC: Mode of action of ceftazidime: affinity for the penicillin-binding proteins of Escherichia coli K12, Pseudomonas aeruginosa and Staphylococcus aureus. J Antimicrob Chemother. 1983 Aug;12(2):119-26. [Article]
2. Richards DM, Brogden RN: Ceftazidime. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use. Drugs. 1985 Feb;29(2):105-61. doi: 10.2165/00003495-198529020-00002. [Article]
3. Davies TA, Shang W, Bush K, Flamm RK: Affinity of doripenem and comparators to penicillin-binding proteins in Escherichia coli and Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2008 Apr;52(4):1510-2. doi: 10.1128/AAC.01529-07. Epub 2008 Feb 4. [Article]
4. Penwell WF, Shapiro AB, Giacobbe RA, Gu RF, Gao N, Thresher J, McLaughlin RE, Huband MD, DeJonge BL, Ehmann DE, Miller AA: Molecular mechanisms of sulbactam antibacterial activity and resistance determinants in Acinetobacter baumannii. Antimicrob Agents Chemother. 2015 Mar;59(3):1680-9. doi: 10.1128/AAC.04808-14. Epub 2015 Jan 5. [Article]
5. Sutaria DS, Moya B, Green KB, Kim TH, Tao X, Jiao Y, Louie A, Drusano GL, Bulitta JB: First Penicillin-Binding Protein Occupancy Patterns of beta-Lactams and beta-Lactamase Inhibitors in Klebsiella pneumoniae. Antimicrob Agents Chemother. 2018 May 25;62(6). pii: AAC.00282-18. doi: 10.1128/AAC.00282-18. Print 2018 Jun. [Article]

Details4. Penicillin-binding protein 2

Kind

Protein

Organism

Escherichia coli (strain K12)

Pharmacological action

Yes

Actions

Inhibitor

Curator comments

The above was chosen as a representative target protein in a representative bacterium, and does not encompass all proteins/bacteria affected by this agent.

General Function

Serine-type d-ala-d-ala carboxypeptidase activity

Specific Function

Cell wall formation; PBP-2 is responsible for the determination of the rod shape of the cell. It synthesizes cross-linked peptidoglycan from lipid intermediates.

Gene Name

mrdA

Uniprot ID

P0AD65

Uniprot Name

Penicillin-binding protein 2

Molecular Weight

70856.1 Da

References

1. Hayes MV, Orr DC: Mode of action of ceftazidime: affinity for the penicillin-binding proteins of Escherichia coli K12, Pseudomonas aeruginosa and Staphylococcus aureus. J Antimicrob Chemother. 1983 Aug;12(2):119-26. [Article]
2. Richards DM, Brogden RN: Ceftazidime. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use. Drugs. 1985 Feb;29(2):105-61. doi: 10.2165/00003495-198529020-00002. [Article]
3. Davies TA, Shang W, Bush K, Flamm RK: Affinity of doripenem and comparators to penicillin-binding proteins in Escherichia coli and Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2008 Apr;52(4):1510-2. doi: 10.1128/AAC.01529-07. Epub 2008 Feb 4. [Article]
4. Penwell WF, Shapiro AB, Giacobbe RA, Gu RF, Gao N, Thresher J, McLaughlin RE, Huband MD, DeJonge BL, Ehmann DE, Miller AA: Molecular mechanisms of sulbactam antibacterial activity and resistance determinants in Acinetobacter baumannii. Antimicrob Agents Chemother. 2015 Mar;59(3):1680-9. doi: 10.1128/AAC.04808-14. Epub 2015 Jan 5. [Article]
5. Sutaria DS, Moya B, Green KB, Kim TH, Tao X, Jiao Y, Louie A, Drusano GL, Bulitta JB: First Penicillin-Binding Protein Occupancy Patterns of beta-Lactams and beta-Lactamase Inhibitors in Klebsiella pneumoniae. Antimicrob Agents Chemother. 2018 May 25;62(6). pii: AAC.00282-18. doi: 10.1128/AAC.00282-18. Print 2018 Jun. [Article]

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Drug created on June 13, 2005 13:24 / Updated on July 24, 2021 14:57