CEFTAZIDIME is a valuable third-generation bactericidal cephalosporin. CEFTAZIDIME inhibits the biosynthesis of bacterial cell peptidoglycan, causing inhibition of bacterial growth or cell lyses and death. Common nosocomial gram-negative organisms susceptible to CEFTAZIDIME include Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, Neisseria, Moraxella catarrhalis, Proteus mirabilis, Proteus vulgaris, and Providencia stuartii. Good activity remains against other gram-negative species including Salmonella, Shigella, and Neisseria species. CEFTAZIDIME is widely distributed in most body tissues and fluids including respiratory secretion, ascitic fluid and cerebrospinal fluid. CEFTAZIDIME is administered parenterally, is completely absorbed after intramuscular injection, and peak drug concentrations generally occur within 3 hours of intramuscular injection. CEFTAZIDIME is not absorbed when taken by mouth. CEFTAZIDIME half-life is 4 to 10 hours at birth, but half this in infants more than a week old. In premature infants, the distribution volume and the clearance of CEFTAZIDIME range from 292+44 to 366+130 ml/kg and from 27. 8+5. 8 to 60. 8+8. 3 ml/h/kg, respectively. CEFTAZIDIME binds to plasma proteins at 10% to 17%. No CEFTAZIDIME metabolites have been identified and this drug is excreted by renal elimination. The dose of CEFTAZIDIME is 25 mg/kg once-daily in the first week of life. CEFTAZIDIME crosses the placenta freely, but there is no evidence of teratogenicity. As empirical CEFTAZIDIME monotherapy may not be appropriate for the treatment of neonatal sepsis, the addition of ampicillin, to cover against enterococci and Listeria monocytogenes, seems prudent in these neonatal patients. The aim of this study is to review the effects of CEFTAZIDIME in neonates.

Background and Objectives: Carbapenem-resistant Enterobacteriaceae (CRE) infections are extremely difficult to treat and have a high fatality rate. The study's primary goal was to determine the rate of CEFTAZIDIME-avibactam susceptibility using disc diffusion and E-Test, as well as to evaluate the agreement between the two methods. Materials and Methods: A total of 124 multidrug-resistant (including carbapenem) Escherichia coli and Klebisella pneumoniae isolates were included. Kirby Bauer's disc diffusion and E-test were used as the testing methods in this study. Results: In this study 37.5% and 33.9% of the isolates were susceptible to CEFTAZIDIME-avibactam by E test and Disc diffusion respectively. There were five isolates which produced discordant results. Among the 56 isolates there was 91% agreement between the two methods. Conclusion: Among the discordant isolates the alarming disparity in zone size was a significant concern. Since CRE infections are very common, an economical and practical method for testing CEFTAZIDIME-avibactam susceptibility is needed in all the clinical microbiology laboratories as it is a last resort drug.

Introduction: Contrary to conventional imaging techniques like CT and MRI, scintigraphic imaging is based on physiological and biochemical alterations resulting from inflammatory and infectious processes. A new proposal is based on the use of radiolabeled antibiotics. They are used as specific infection imaging because of their affinity to bind with bacteria. Antibiotics localize in the infectious focus, where they are frequently taken up and metabolized by microorganisms. The majority of the various antibiotics studied so far are those of the quinolones group. Recently, a new radiopharmaceutical, 99mTc-ciprofloxacin (Infecton), has been developed. CEFTAZIDIME a third-generation cephalosporin antibiotic used to treat bacterial infections was investigated to label with 99mTc.Methods: labeling of CEFTAZIDIME with 99mTc was performed by using sodium dithionite as reducing agent.Labeling was performed at 100 ºC for 10 min and radiochemical analysis involved ITLC and HPLC methods.The stability of labeled antibiotic was checked in the presence of human serum at 37 ºC up to 24 h.Results: The maximum radiolabeling yield was 95.5±1.5 %. Bacterial binding assay was performed with S.aureus and the in vivo distribution was studied in mice. Images showed minimal accumulation in non-target tissues, with an average target/non-target ratio of 1.97±0.28.Conclusion: Reaction was easygoing within a very short time which makes it a good radiopharmaceutical for clinical usage in nuclear medicine laboratories. The radiotracer demonstrated excellent radiochemical stability even up to 24 h post labeling. This antibiotic showed an improvement in excretion pathway from liver to kidney followed by an accumulation of radioactivity in infected areas.

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Background: This study compared the efficacy of CEFTAZIDIME-avibactam (CAZ-AVI) with colistin for treating carbapenem-resistant Enterobacteriaceae (CRE) infections. Materials & Methods: This retrospective study included 120 patients with a confirmed CRE infection and information on causative bacteria and their susceptibility pattern. Patients were divided into two groups: those receiving CAZ-AVI and/or aztreonam (n=53) and those receiving colistin (n=67) for at least seven days. The colistin group was further subdivided into those who switched to CAZ-AVI due to poor outcomes. Patient data, including demographics, clinical history, microbiological data, Charlson comorbidity index, and outcomes, were collected and analyzed. Mann-Whitney U, Chi-square, and Fisher’s exact tests were used to compare the groups. P< .05 was considered statistically significant. Findings: The findings revealed comparable clinical characteristics, there were no major differences in mean duration of hospitalization, intensive care unit (ICU) admission, and Charlson scores between the two groups. The CAZ-AVI group required a significantly longer duration of antibiotic treatment (p= .018) and more source control measures (p= .009). Klebsiella pneumoniae was the predominant causative pathogen in both groups, with NDM and OXA48 carbapenem resistance genes being the most common. Toxicity (p= .001) and mortality (p= .049) were significantly higher in the colistin group. Higher improvement was observed among the CAZ-AVI group and higher mortality among the colistin group (p= .049). Conclusion: CAZ-AVI could serve as an alternative to colistin for treating CRE infections. Further research is necessary to confirm these findings and provide evidence-based guidelines for managing CRE infections in India.

Introduction: Infections caused by multidrug-resistant Enterobacterales pose a significant global health challenge, thus necessitating novel therapeutic strategies. The increasing prevalence of carbapenem-resistant Enterobacterales has led to reliance on colistin and polymyxins as last-resort antibiotics. However, emerging colistin resistance and associated polymyxin toxicity have significantly limited their use. Aztreonam is effective against metallo-β-lactamase (MBL)-producing pathogens but requires protection from co-produced enzymes such as extended-spectrum β-lactamases (ESBLs), AmpC cephalosporinases, and other carbapenemases. Avibactam, a non-β-lactam β-lactamase inhibitor, inhibits ESBLs, Klebsiella pneumoniae carbapenemase (KPC), certain oxacillinase (OXA)-48-like enzymes, and AmpC cephalosporinases but is ineffective against metallo-β-lactamases. This study evaluated the in vitro synergy of CEFTAZIDIME-avibactam with aztreonam as a potential colistin-sparing strategy for carbapenem-resistant Enterobacterales infections. Methods: In a prospective cross-sectional study from July 2022 to June 2023, 97 carbapenem-resistant Gram-negative clinical isolates (prevalence: 97/8876 =1. 09%) were obtained from 8876 samples tested for aerobic bacterial culture and antimicrobial susceptibility at a tertiary care hospital in Pune, India. For 69 Enterobacterales isolates resistant to ertapenem, imipenem, and meropenem, synergy between CEFTAZIDIME-avibactam and aztreonam was tested using disk diffusion and modified E-test/disk diffusion method, interpreted as per the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Results: Enterobacterales comprised 69 (71. 13%) of isolates, with 35 (50. 73%) of these demonstrating synergy between CEFTAZIDIME-avibactam and aztreonam. Klebsiella pneumoniae (33/69,47. 83%) was the predominant species, followed by Escherichia coli (26/69,37. 68%) and Citrobacter species (10/69,14. 49%). Conclusion: In vitro synergy between CEFTAZIDIME-avibactam and aztreonam was observed in 50. 73% of carbapenem-resistant Enterobacterales isolates, suggesting a possible colistin-sparing alternative for infections such as complicated urinary tract infections, intra-abdominal infections, and hospital-acquired pneumonia,however, further clinical studies are needed to validate its efficacy.

Objective: The effect of CEFTAZIDIME on Pseudomonas aernginosa, with or without application of 1MHz therapeutic ultrasound, was studied.Method: An aqueous suspension of microorganisms in a sterile, sealed plate was placed in an ultrasonic tank operating at 1MHz. Different power outputs were used. After desired time of exposure to the ultrasound, each sample was plated separately and after incubation, the number of colonies was counted.Results: Results showed that ultrasound in combination with sMICs of CEFTAZIDIME was much more lethal to this bacterium than either of the treatments alone. The mechanism by which ultrasound enhances antibiotic action is due to the induction of uptake of antibiotic by perturbing or stressing the membrane.Conclusion: This application of ultrasound may be useful for expanding the number of drugs available for treating localized infections by rendering bacteria susceptible to normally ineffective antibiotics.

Background: In cancer patients, various infections were developed due to severe neutropenia resulted from chemotherapy. CEFTAZIDIME is commonly used as monotherapy of cancer patients with fever and neutropenia. Meropenem is a new carbapenem with more extended antibacterial spectrum including anaerobes. It provides better coverage against gram positives. This trial compared the efficacy and safety of meropenem with CEFTAZIDIME as empirical monotherapy for febrile neutropenia in pediatric patients with cancer.Materials and Methods: A prospective, double-blind, randomized clinical trial was conducted at Departments of Pediatric Haematology/Oncology, University Hospitals, Yazd, Iran, during the years 2012 to 2013. A total of 48 cancer patients participated in the trial.Result: In this study, 26 patients (54.16%) were treated by CEFTAZIDIME and 22 patients (45.84%) by meropenem. Mean duration of fever in those who responded to treatment in CEFTAZIDIME group was 19.43+/-31.04 hours, and in meropenem group was 16.53+/-28.77 hours (P-value=0.965). Conclusion: Finding of this study indicate that CEFTAZIDIME and meropenem have similar efficacy in treatment of fever and sever neutropenia. Due to more availability and lower cost of CEFTAZIDIME than meropenem, CEFTAZIDIME is suggested as a first line treatment in fever and neutropenia.