Ceftazidime: therapeutic results in various infections and kinetic studies

Forty-five patients with acute or recurrent pyelonephritis (32), lower respiratory infection (7) or various other serious infections (6), were treated with ceftazidime. Most infections were severe, often in the presence of aggravating factors, and had failed to respond to previous antibiotic therapy. Infecting organisms were Escherichia coli (23), other Enterobacteriaceae (5), Pseudomonas aeruginosa (11), mixed flora including Ps. aeruginosa (3) and Staphylococcus albus (1). The organisms were often multiresistant. Dosage ranged from 1 to 6 g daily im or iv. All patients were clinically cured, except two who only improved. In 35 patients the organisms were eradicated, in two partially eradicated, and in six persisted or recurred. Most bacteriological failures were observed in patients infected with Ps. aeruginosa. Tolerance of the drug was excellent. A transient leucopenia was observed in one patient and transient high SGOT and LDH in another. After an intramuscular dose of 1 g im serum levels were 33 mg/1 at 2 h, 13-7 mg/1 at 6 h and 8-5 mg/1 at 12 h. The average half-life was 2-6 h. Urinary levels were high and 79-92 % of the dose was recovered from the urine after 12 h. After 3 days therapy with 1 and 2 g im 12-hourly, bone levels exceeded 10 and 15 mg/1, respectively. Ceftazidime was a safe and effective drug for the treatment of infection. A dose of 0-5 g 12-hourly is sufficient for urinary infections, but higher doses are needed in other infections, especially when due to Ps. aeruginosa