Ceftizoxime: Indication, Dosage, Side Effect, Precaution

This information is not country-specific. Please refer to the Indonesia prescribing information.

Generic Medicine Info

Indications and Dosage

Intramuscular
Uncomplicated gonorrhoea

Adult: 1 g as a single dose.

Parenteral
Uncomplicated urinary tract infections

Adult: 0.5 g 12 hrly given as deep IM or slow IV inj over 3-5 min.

Parenteral
Susceptible infections

Adult: 1-2 g 8-12 hrly given as deep IM or slow IV inj over 3-5 min, increased to 2-4 g IV 8 hrly in severe infections. Max: 2 g 4 hrly.
Child: ≥6 mth 50 mg/kg 6-8 hrly.

Renal Impairment

Loading dose: 0.5-1 g. Maintenance: According to CrCl and severity of infection.

CrCl (mL/min)	Dosage
<5	0.25-0.5 g 24 hrly or 0.5-1 g 48 hrly, after dialysis.
5-49	0.25-1 g 12 hrly.
50-79	0.5-1.5 g 8 hrly.

Contraindications

Hypersensitivity to ceftizoxime.

Special Precautions

Patient w/ history of GI disease, particularly colitis; hypersensitivity to penicillins. Renal impairment. Pregnancy and lactation.

Adverse Reactions

Rash, pruritus, fever; transient elevation in AST, ALT and alkaline phosphatase; transient eosinophilia, thrombocytosis; burning, cellulitis, phlebitis, pain, induration and tenderness at inj site, paraesthesia; nausea, vomiting, diarrhoea; transient rise in BUN and creatinine. Rarely, anaemia, neutropenia, leucopenia, thrombocytopenia, vaginitis, numbness.
Potentially Fatal: Anaphylaxis, pseudomembranous colitis.

Pregnancy Category (US FDA)

IM/IV/Parenteral: B

Monitoring Parameters

Carefully monitor renal function.

Drug Interactions

Renal clearance reduced w/ probenecid.

Lab Interference

May develop positive Coomb's test.

Action

Description:
Mechanism of Action: Ceftizoxime binds to 1 or more of the penicillin-binding proteins (PBPs) which inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Pharmacokinetics:
Absorption: Time to peak plasma concentration: 1 hr.
Distribution: Widely distributed in body tissues and fluids; occur in CSF (therapeutic concentrations) when meninges are inflamed. Crosses the placenta and enters breast milk (low concentrations). Plasma protein binding: 30%.
Excretion: Via urine as unchanged drug w/in 24 hr. Plasma half-life: Approx 1.7 hr.

Chemical Structure

Storage

Store at -20°C.

MIMS Class

Cephalosporins

ATC Classification

J01DD07 - ceftizoxime ; Belongs to the class of third-generation cephalosporins. Used in the systemic treatment of infections.

References

Buckingham R (ed). Ceftizoxime Sodium. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/11/2014.

Cefizox Solution (Astellas Pharma US, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 13/11/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Cephalosporins General Statement. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 25/08/2015.

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