U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C22H21N6O7S2.H
Molecular Weight 546.576
Optical Activity UNSPECIFIED
Defined Stereocenters 2 / 2
E/Z Centers 1
Charge 0

SHOW SMILES / InChI
Structure of CEFTAZIDIME ANHYDROUS, (E)-

SMILES

[H+].[H][C@]12SCC(C[N+]3=CC=CC=C3)=C(N1C(=O)[C@H]2NC(=O)C(=N\OC(C)(C)C([O-])=O)\C4=CSC(N)=N4)C([O-])=O

InChI

InChIKey=ORFOPKXBNMVMKC-KZBLUZIOSA-N
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

HIDE SMILES / InChI

Molecular Formula H
Molecular Weight 1.0079
Charge 1
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Molecular Formula C22H21N6O7S2
Molecular Weight 545.568
Charge -1
Count
Stereochemistry ABSOLUTE
Additional Stereochemistry No
Defined Stereocenters 2 / 2
E/Z Centers 1
Optical Activity UNSPECIFIED

Ceftazidime is a semisynthetic, broad-spectrum, beta-lactam antibiotic, used especially for Pseudomonas and other gram-negative infections in debilitated patients. Ceftazidime is used to treat lower respiratory tract, skin, urinary tract, blood-stream, joint, and abdominal infections, and meningitis. The drug is given intravenously (IV) or intramuscularly (IM) every 8–12 hours (two or three times a day), with dose and frequency varying by the type of infection, severity, and/or renal function of the patient. Injectable formulations of ceftazidime are currently nebulized "off-label" to manage Cystic Fibrosis, non-Cystic Fibrosis bronchiectasis, drug-resistant nontuberculous mycobacterial infections, ventilator-associated pneumonia, and post-transplant airway infections. Ceftazidime is generally well-tolerated. When side effects do occur, they are most commonly local effects from the intravenous line site, allergic reactions, and gastrointestinal symptoms. According to one manufacturer, in clinical trials, allergic reactions including itching, rash, and fever, happened in fewer than 2% of patients. Rare but more serious allergic reactions, such as toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme, have been reported with this class of antibiotics, including ceftazidime. Gastrointestinal symptoms, including diarrhea, nausea, vomiting, and abdominal pain, were reported in fewer than 2% of patients.

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Curative
FORTAZ

Approved Use

Ceftazidime for injection, USP is indicated for the treatment of patients with infections caused by susceptible strains of the designated organisms in the following diseases: Lower Respiratory Tract Infections, including pneumonia, caused by Pseudomonas aeruginosa and other Pseudomonas spp.; Haemophilus influenzae, including ampicillin-resistant strains; Klebsiella spp.; Enterobacter spp.; Proteus mirabilis; Escherichia coli; Serratia spp.; Citrobacter spp.; Streptococcus pneumoniae; and Staphylococcus aureus (methicillin-susceptible strains). Skin and Skin-Structure Infections caused by Pseudomonas aeruginosa; Klebsiella spp.; Escherichia coli; Proteus spp., including Proteus mirabilis and indole-positive Proteus; Enterobacter spp.; Serratia spp.; Staphylococcus aureus (methicillin-susceptible strains); and Streptococcus pyogenes (group A beta-hemolytic streptococci). Urinary Tract Infections, both complicated and uncomplicated, caused by Pseudomonas aeruginosa; Enterobacter spp.; Proteus spp., including Proteus mirabilis and indole-positive Proteus; Klebsiella spp.; and Escherichia coli. Bacterial Septicemia caused by Pseudomonas aeruginosa, Klebsiella spp., Haemophilus influenzae, Escherichia coli, Serratia spp., Streptococcus pneumoniae, and Staphylococcus aureus (methicillin-susceptible strains). Bone and Joint Infections caused by Pseudomonas aeruginosa, Klebsiella spp., Enterobacter spp., and Staphylococcus aureus (methicillin-susceptible strains). Gynecologic Infections, including endometritis, pelvic cellulitis, and other infections of the female genital tract caused by Escherichia coli. Intra-abdominal Infections, including peritonitis caused by Escherichia coli, Klebsiella spp., and Staphylococcus aureus (methicillin-susceptible strains) and polymicrobial infections caused by aerobic and anaerobic organisms and Bacteroides spp. (many strains of Bacteroides fragilis are resistant). Central Nervous System Infections, including meningitis, caused by Haemophilus influenzae and Neisseria meningitidis. Ceftazidime for injection, USP has also been used successfully in a limited number of cases of meningitis due to Pseudomonas aeruginosa and Streptococcus pneumoniae. Ceftazidime for injection, USP may be used alone in cases of confirmed or suspected sepsis. Ceftazidime for injection, USP has been used successfully in clinical trials as empiric therapy in cases where various concomitant therapies with other antibiotics have been used. Ceftazidime for injection, USP may also be used concomitantly with other antibiotics, such as aminoglycosides, vancomycin, and clindamycin; in severe and life-threatening infections; and in the immunocompromised patient. When such concomitant treatment is appropriate, prescribing information in the labeling for the other antibiotics should be followed. The dose depends on the severity of the infection and the patient's condition. To reduce the development of drug-resistant bacteria and maintain the effectiveness of ceftazidime for injection, USP and other antibacterial drugs, ceftazidime for injection, USP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Launch Date

1985
Curative
FORTAZ

Approved Use

Ceftazidime for injection, USP is indicated for the treatment of patients with infections caused by susceptible strains of the designated organisms in the following diseases: Lower Respiratory Tract Infections, including pneumonia, caused by Pseudomonas aeruginosa and other Pseudomonas spp.; Haemophilus influenzae, including ampicillin-resistant strains; Klebsiella spp.; Enterobacter spp.; Proteus mirabilis; Escherichia coli; Serratia spp.; Citrobacter spp.; Streptococcus pneumoniae; and Staphylococcus aureus (methicillin-susceptible strains). Skin and Skin-Structure Infections caused by Pseudomonas aeruginosa; Klebsiella spp.; Escherichia coli; Proteus spp., including Proteus mirabilis and indole-positive Proteus; Enterobacter spp.; Serratia spp.; Staphylococcus aureus (methicillin-susceptible strains); and Streptococcus pyogenes (group A beta-hemolytic streptococci). Urinary Tract Infections, both complicated and uncomplicated, caused by Pseudomonas aeruginosa; Enterobacter spp.; Proteus spp., including Proteus mirabilis and indole-positive Proteus; Klebsiella spp.; and Escherichia coli. Bacterial Septicemia caused by Pseudomonas aeruginosa, Klebsiella spp., Haemophilus influenzae, Escherichia coli, Serratia spp., Streptococcus pneumoniae, and Staphylococcus aureus (methicillin-susceptible strains). Bone and Joint Infections caused by Pseudomonas aeruginosa, Klebsiella spp., Enterobacter spp., and Staphylococcus aureus (methicillin-susceptible strains). Gynecologic Infections, including endometritis, pelvic cellulitis, and other infections of the female genital tract caused by Escherichia coli. Intra-abdominal Infections, including peritonitis caused by Escherichia coli, Klebsiella spp., and Staphylococcus aureus (methicillin-susceptible strains) and polymicrobial infections caused by aerobic and anaerobic organisms and Bacteroides spp. (many strains of Bacteroides fragilis are resistant). Central Nervous System Infections, including meningitis, caused by Haemophilus influenzae and Neisseria meningitidis. Ceftazidime for injection, USP has also been used successfully in a limited number of cases of meningitis due to Pseudomonas aeruginosa and Streptococcus pneumoniae. Ceftazidime for injection, USP may be used alone in cases of confirmed or suspected sepsis. Ceftazidime for injection, USP has been used successfully in clinical trials as empiric therapy in cases where various concomitant therapies with other antibiotics have been used. Ceftazidime for injection, USP may also be used concomitantly with other antibiotics, such as aminoglycosides, vancomycin, and clindamycin; in severe and life-threatening infections; and in the immunocompromised patient. When such concomitant treatment is appropriate, prescribing information in the labeling for the other antibiotics should be followed. The dose depends on the severity of the infection and the patient's condition. To reduce the development of drug-resistant bacteria and maintain the effectiveness of ceftazidime for injection, USP and other antibacterial drugs, ceftazidime for injection, USP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Launch Date

1985
Curative
FORTAZ

Approved Use

Ceftazidime for injection, USP is indicated for the treatment of patients with infections caused by susceptible strains of the designated organisms in the following diseases: Lower Respiratory Tract Infections, including pneumonia, caused by Pseudomonas aeruginosa and other Pseudomonas spp.; Haemophilus influenzae, including ampicillin-resistant strains; Klebsiella spp.; Enterobacter spp.; Proteus mirabilis; Escherichia coli; Serratia spp.; Citrobacter spp.; Streptococcus pneumoniae; and Staphylococcus aureus (methicillin-susceptible strains). Skin and Skin-Structure Infections caused by Pseudomonas aeruginosa; Klebsiella spp.; Escherichia coli; Proteus spp., including Proteus mirabilis and indole-positive Proteus; Enterobacter spp.; Serratia spp.; Staphylococcus aureus (methicillin-susceptible strains); and Streptococcus pyogenes (group A beta-hemolytic streptococci). Urinary Tract Infections, both complicated and uncomplicated, caused by Pseudomonas aeruginosa; Enterobacter spp.; Proteus spp., including Proteus mirabilis and indole-positive Proteus; Klebsiella spp.; and Escherichia coli. Bacterial Septicemia caused by Pseudomonas aeruginosa, Klebsiella spp., Haemophilus influenzae, Escherichia coli, Serratia spp., Streptococcus pneumoniae, and Staphylococcus aureus (methicillin-susceptible strains). Bone and Joint Infections caused by Pseudomonas aeruginosa, Klebsiella spp., Enterobacter spp., and Staphylococcus aureus (methicillin-susceptible strains). Gynecologic Infections, including endometritis, pelvic cellulitis, and other infections of the female genital tract caused by Escherichia coli. Intra-abdominal Infections, including peritonitis caused by Escherichia coli, Klebsiella spp., and Staphylococcus aureus (methicillin-susceptible strains) and polymicrobial infections caused by aerobic and anaerobic organisms and Bacteroides spp. (many strains of Bacteroides fragilis are resistant). Central Nervous System Infections, including meningitis, caused by Haemophilus influenzae and Neisseria meningitidis. Ceftazidime for injection, USP has also been used successfully in a limited number of cases of meningitis due to Pseudomonas aeruginosa and Streptococcus pneumoniae. Ceftazidime for injection, USP may be used alone in cases of confirmed or suspected sepsis. Ceftazidime for injection, USP has been used successfully in clinical trials as empiric therapy in cases where various concomitant therapies with other antibiotics have been used. Ceftazidime for injection, USP may also be used concomitantly with other antibiotics, such as aminoglycosides, vancomycin, and clindamycin; in severe and life-threatening infections; and in the immunocompromised patient. When such concomitant treatment is appropriate, prescribing information in the labeling for the other antibiotics should be followed. The dose depends on the severity of the infection and the patient's condition. To reduce the development of drug-resistant bacteria and maintain the effectiveness of ceftazidime for injection, USP and other antibacterial drugs, ceftazidime for injection, USP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Launch Date

1985
Primary
FORTAZ

Approved Use

Ceftazidime for injection, USP is indicated for the treatment of patients with infections caused by susceptible strains of the designated organisms in the following diseases: Lower Respiratory Tract Infections, including pneumonia, caused by Pseudomonas aeruginosa and other Pseudomonas spp.; Haemophilus influenzae, including ampicillin-resistant strains; Klebsiella spp.; Enterobacter spp.; Proteus mirabilis; Escherichia coli; Serratia spp.; Citrobacter spp.; Streptococcus pneumoniae; and Staphylococcus aureus (methicillin-susceptible strains). Skin and Skin-Structure Infections caused by Pseudomonas aeruginosa; Klebsiella spp.; Escherichia coli; Proteus spp., including Proteus mirabilis and indole-positive Proteus; Enterobacter spp.; Serratia spp.; Staphylococcus aureus (methicillin-susceptible strains); and Streptococcus pyogenes (group A beta-hemolytic streptococci). Urinary Tract Infections, both complicated and uncomplicated, caused by Pseudomonas aeruginosa; Enterobacter spp.; Proteus spp., including Proteus mirabilis and indole-positive Proteus; Klebsiella spp.; and Escherichia coli. Bacterial Septicemia caused by Pseudomonas aeruginosa, Klebsiella spp., Haemophilus influenzae, Escherichia coli, Serratia spp., Streptococcus pneumoniae, and Staphylococcus aureus (methicillin-susceptible strains). Bone and Joint Infections caused by Pseudomonas aeruginosa, Klebsiella spp., Enterobacter spp., and Staphylococcus aureus (methicillin-susceptible strains). Gynecologic Infections, including endometritis, pelvic cellulitis, and other infections of the female genital tract caused by Escherichia coli. Intra-abdominal Infections, including peritonitis caused by Escherichia coli, Klebsiella spp., and Staphylococcus aureus (methicillin-susceptible strains) and polymicrobial infections caused by aerobic and anaerobic organisms and Bacteroides spp. (many strains of Bacteroides fragilis are resistant). Central Nervous System Infections, including meningitis, caused by Haemophilus influenzae and Neisseria meningitidis. Ceftazidime for injection, USP has also been used successfully in a limited number of cases of meningitis due to Pseudomonas aeruginosa and Streptococcus pneumoniae. Ceftazidime for injection, USP may be used alone in cases of confirmed or suspected sepsis. Ceftazidime for injection, USP has been used successfully in clinical trials as empiric therapy in cases where various concomitant therapies with other antibiotics have been used. Ceftazidime for injection, USP may also be used concomitantly with other antibiotics, such as aminoglycosides, vancomycin, and clindamycin; in severe and life-threatening infections; and in the immunocompromised patient. When such concomitant treatment is appropriate, prescribing information in the labeling for the other antibiotics should be followed. The dose depends on the severity of the infection and the patient's condition. To reduce the development of drug-resistant bacteria and maintain the effectiveness of ceftazidime for injection, USP and other antibacterial drugs, ceftazidime for injection, USP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Launch Date

1985
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
21.3 μg × h/mL
75 mg/kg other, intravenous
dose: 75 mg/kg
route of administration: Intravenous
experiment type: OTHER
co-administered:
CEFTAZIDIME serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
18 μg × h/mL
75 mg/kg 1 times / day other, intravenous
dose: 75 mg/kg
route of administration: Intravenous
experiment type: OTHER
co-administered:
CEFTAZIDIME unknown
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
285 μg × h/mL
25 mg/kg 3 times / day multiple, intravenous
dose: 25 mg/kg
route of administration: Intravenous
experiment type: MULTIPLE
co-administered:
CEFTAZIDIME serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
9.6 min
25 mg/kg 3 times / day multiple, intravenous
dose: 25 mg/kg
route of administration: Intravenous
experiment type: MULTIPLE
co-administered:
CEFTAZIDIME serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
1 g 3 times / day multiple, intravenous
Highest studied dose
Dose: 1 g, 3 times / day
Route: intravenous
Route: multiple
Dose: 1 g, 3 times / day
Sources:
unhealthy, adult
n = 1
Health Status: unhealthy
Condition: pneumonia
Age Group: adult
Sex: unknown
Population Size: 1
Sources:
300 mg/kg 14 times / day multiple, intravenous
Highest studied dose
Dose: 300 mg/kg, 14 times / day
Route: intravenous
Route: multiple
Dose: 300 mg/kg, 14 times / day
Sources:
unhealthy, children
n = 15
Health Status: unhealthy
Condition: cystic fibrosis
Age Group: children
Sex: unknown
Population Size: 15
Sources:
Other AEs: Urticaria, Itchy rash...
Other AEs:
Urticaria (3 patients)
Itchy rash (4 patients)
Sources:
AEs

AEs

AESignificanceDosePopulation
Urticaria 3 patients
300 mg/kg 14 times / day multiple, intravenous
Highest studied dose
Dose: 300 mg/kg, 14 times / day
Route: intravenous
Route: multiple
Dose: 300 mg/kg, 14 times / day
Sources:
unhealthy, children
n = 15
Health Status: unhealthy
Condition: cystic fibrosis
Age Group: children
Sex: unknown
Population Size: 15
Sources:
Itchy rash 4 patients
300 mg/kg 14 times / day multiple, intravenous
Highest studied dose
Dose: 300 mg/kg, 14 times / day
Route: intravenous
Route: multiple
Dose: 300 mg/kg, 14 times / day
Sources:
unhealthy, children
n = 15
Health Status: unhealthy
Condition: cystic fibrosis
Age Group: children
Sex: unknown
Population Size: 15
Sources:
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG



Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
no
no
no
no
no
no
no
no
no
no
no
no
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
inconclusive
inconclusive
inconclusive
inconclusive
inconclusive
inconclusive
inconclusive
inconclusive
inconclusive
inconclusive
inconclusive
no
no
no
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
Sourcing

Sourcing

Vendor/AggregatorIDURL
PubMed

PubMed

TitleDatePubMed
Efficacy of ciprofloxacin in animal models of infection: endocarditis, meningitis, and pneumonia.
1987 Apr 27
Ceftazidime-induced encephalopathy in a patient with renal impairment.
1988 Sep
Animal models as predictors of outcome of therapy with broad spectrum cephalosporins.
1992 Apr
Ceftazidime encephalopathy: absence status and toxic hallucinations.
1992 Apr
QT prolongation and Torsades de Pointes associated with clarithromycin.
1998 Apr
[Basic and clinical studies on tazobactam/piperacillin in pediatric field].
1998 Jun
Meningitis caused by Enterococcus gallinarum in patients with ventriculoperitoneal shunts.
2003 Dec
Retrospective review of neurotoxicity induced by cefepime and ceftazidime.
2003 Mar
Prediction of genotoxicity of chemical compounds by statistical learning methods.
2005 Jun
One center's experience: the serology and drugs associated with drug-induced immune hemolytic anemia--a new paradigm.
2007 Apr
Multichannel liquid chromatography-tandem mass spectrometry cocktail method for comprehensive substrate characterization of multidrug resistance-associated protein 4 transporter.
2007 Dec
Ceftazidime-associated biliary sludge in neonatal sepsis: a first report.
2009 Dec
Systems pharmacological analysis of drugs inducing stevens-johnson syndrome and toxic epidermal necrolysis.
2015 May 18
Patents

Sample Use Guides

The usual adult dosage is 1 gram administered intravenously or intramuscularly every 8 to 12 hours. The dosage and route should be determined by the susceptibility of the causative organisms, the severity of infection, and the condition and renal function of the patient.
Route of Administration: Other
Ceftazidime–avibactam and comparator antibacterial agents were tested by reference broth microdilution against 417non-repetitive Gram-negative bacilli (387 unselected, plus 30selected blaKPC-positive, meropenem – nonsusceptible, Kleb-siella pneumoniae) collected prospectively from medical centersat Hospital das Clínicas da Faculdade de Medicina da Uni-versidade de São Paulo, Brazil, in 2014 and 2015. Minimum inhibitory concentrations (MICs), one per isolate, were determined by reference Clinical and Laboratory Standards Institute (CLSI) broth microdilution methods using frozen microtiter plates pre-loaded with antibiotic-containing growth medium. MICs ofceftazidime–avibactam were measured by varying the concen-tration of ceftazidime in twofold increments with avibactamat a fixed concentration of 4 mg/L. Addition of avibactam at 4 mg/L decreased MICs of cef-tazidime against unselected Enterobacteriaceae, especially K.pneumoniae, Citrobacter freundii, and Enterobacter cloacae, among which MIC90values decreased from 128 to >128 mg/L to0.5–4 mg/L. Among the unselected isolates of these three species 37–73% were susceptible to ceftazidime, whereas 100%were susceptible to ceftazidime–avibactam.
Substance Class Chemical
Created
by admin
on Sat Dec 16 05:11:31 GMT 2023
Edited
by admin
on Sat Dec 16 05:11:31 GMT 2023
Record UNII
UU1494IX6R
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
CEFTAZIDIME ANHYDROUS, (E)-
Common Name English
CEFTAZIDIME PENTAHYDRATE IMPURITY B [EP IMPURITY]
Common Name English
PYRIDINIUM, 1-(((6R,7R)-7-(((2E)-(2-AMINO-4-THIAZOLYL)((1-CARBOXY-1-METHYLETHOXY)IMINO)ACETYL)AMINO)-2-CARBOXY-8-OXO-5-THIA-1-AZABICYCLO(4.2.0)OCT-2-EN-3-YL)METHYL)-, INNER SALT
Common Name English
CEFTAZIDIME IMPURITY B [EP IMPURITY]
Common Name English
(6R,7R)-7-(((2E)-2-(2-AMINOTHIAZOL-4-YL)-2-((1-CARBOXY-1-METHYLETHOXY)IMINO)ACETYL)AMINO)-8-OXO-3-((PYRIDIN-1-IUM-1-YL)METHYL)-5-THIA-1-AZABICYCLO(4.2.0)OCT-2-ENE-2-CARBOXYLATE
Systematic Name English
Code System Code Type Description
PUBCHEM
5484131
Created by admin on Sat Dec 16 05:11:32 GMT 2023 , Edited by admin on Sat Dec 16 05:11:32 GMT 2023
PRIMARY
EPA CompTox
DTXSID10242717
Created by admin on Sat Dec 16 05:11:32 GMT 2023 , Edited by admin on Sat Dec 16 05:11:32 GMT 2023
PRIMARY
FDA UNII
UU1494IX6R
Created by admin on Sat Dec 16 05:11:32 GMT 2023 , Edited by admin on Sat Dec 16 05:11:32 GMT 2023
PRIMARY
CAS
97148-38-4
Created by admin on Sat Dec 16 05:11:32 GMT 2023 , Edited by admin on Sat Dec 16 05:11:32 GMT 2023
PRIMARY
Related Record Type Details
PARENT -> IMPURITY
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP