Dosing and uses of Cefizox (ceftizoxime)
Adult dosage forms and strengths
powder for injection
- 500mg
- 1g
- 2g
- 10g
Gonorrhea (Uncomplicated)
1 g IM (single) dose; 1 g/day maximum
Pelvic Inflammatory Disease
2 g IV q8hr; 6 g/day maximum
Urinary Tract Infection (Uncomplicated)
500 mg IV/IM q12hr
Other Infection Sites
1 g IV/IM q8-12hr
Severe or Refractory Infection
1 g IV/IM q8hr; 2 g q8-12hr IV/Im
Life-Threatening Infection
3-4 g IV q8hr; 9-12 g/day maximum
Renal Impairment
CrCl 50-79 mL/min: 500 mg-1.5 g q8hr
CrCl 5-49 mL/min: 250 mg-1 g q12hr
CrCl <5 mL/min: 250 mg-500 mg qDay or 500 mg-1 g q48hr
Other Indications & Uses
Anaerobic cocci, Bacteroides spp., Citrobacter spp., Clostridium spp., Enterobacter spp., E. coli, H. influenzae, Klebsiella spp., M. morganii, N. gonorrhoeae, P. mirabilis, Providencia rettgeri, Pseudomonas spp., Serratia spp., S. aureus, S. pneumoniae, S. pyogenes
Pediatric dosage forms and strengths
powder for injection
- 500mg
- 1g
- 2g
- 10g
Infections
Neonates (off-label): 25-50 mg/kg IV q12hr
<6 months old (off-label): 100-200 mg/kg/day IV divided q8hr
>6 months old: 150-200 mg/kg/dose IV divided q6-8hr; dosage may be increased to total daily dose of 200 mg/kg
Severe Infection
Neonates (off-label): 25-50 mg/kg IV q12hr
<6 months old: 100-200 mg/kg/day divided q8hr IV
>6 months old: 200 mg/kg/day IV divided q6-8hr; 12 g/day maximum
Cefizox (ceftizoxime) adverse (side) effects
1-10%
Fever
Pruritus
Rash
Eosinophilia
Thrombocytosis
Elevated transaminases, alkaline phosphatase
Burning at injection site
<1%
Anaphylaxis
Diarrhea
Nausea/vomiting
Injection site reactions
Phlebitis
Paresthesia
Numbness
Increased bilirubin
Increased BUn
Increased creatinine
Anemia
Leukopenia
Neutropenia
Thrombocytopenia
Vaginitis
Warnings
Contraindications
Documented hypersensitivity
Cautions
Adjust dose in renal impairment; transaminitis, anemia, leukopenia, thrombocytopenia, transient elevations in BUN/creatinine, or GI adverse effects may occur
Pregnancy and lactation
Pregnancy category: B
Lactation: excreted in breast milk; use with caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Cefizox (ceftizoxime)
Half-Life: 1.6-1.9 hr, CrCl <10 mL/min: 25 hr
Peak Plasma Time: IM: 0.5-1 hr
Protein Bound: 30%
Distribution: widely into most body tissues & fluids including gallbladder, liver, kidneys, bone, sputum, bile, pleural & synovial fluids; has good CSF penetration; crosses placenta; small amounts enter breast milk
Vd: 0.35-0.5 L/kg
Excretion: urine, as unchanged drug
Mechanism of action
Third-generation cephalosporin with broad-spectrum gram-negative activity; lower efficacy against gram-positive organisms; higher efficacy against resistant organisms. Arrests bacterial growth by binding to one or more penicillin-binding proteins
Administration
IV Incompatibilities
Y-site: filgrastim
IV Preparation
Intermittent Injection: add 5, 10, or 20 mL SWI to 500 mg, 1 g, 2 g of ceftizoxime, respectively
Intermittent/continuous infusion: dilute reconstituted soln w/ 50-100 mL D5W or Ns
IM Injection: add 1.5, 3, or 6 mL SWI to 500 mg, 1 g, or 2 g of ceftizoxime, respectively
IV Administration
Intermittent Injection: directly into vein over 3-5 min
Intermittent/continuous infusion: over 15-30 min
IM Injection: deeply into large muscle, if administering 2 g, div in 2 doses to 2 different muscle masses
