頭孢他啶
Ceftazidime
Ceftazidimum
別名: Fortaz · Ceptaz · Tazicef · Tazidime · Fortum · Ceftazidimum · GR-20263 · LY-139381
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Initial antibiotic therapy of gram-negative infections | 25 mg/kg | IM or SC | q8-12h | — | 🌎 NA |
| Initial treatment of orthopedic infections | 25 mg/kg | IV, IM | q8-12h | — | 🌎 NA |
| Initial treatment of soft tissue infections | 30-50 mg/kg | IV, IM | q8-12h | — | 🌎 NA |
| Initial treatment of sepsis, bacteremia | 15-30 mg/kg | IV, IM | q6-8h | — | 🌎 NA |
| Susceptible infections | 30 mg/kg | IV/IM/SC | q8h | — | 🌍 EU |
| Pseudomonas aeruginosa infections | 30 mg/kg | IV/IM/SC | q4h | — | 🌍 EU |
| Pseudomonas aeruginosa infections (CRI) | 4.4 mg/kg loading dose followed by 4.1 mg/kg/h | IV | CRI | — | 🌍 EU |
- Susceptible infections: Empirical dose; maintain tissue concentrations above MIC.
- Pseudomonas aeruginosa infections: Increased frequency required for Pseudomonas.
- Pseudomonas aeruginosa infections (CRI): Continuous rate infusion to maintain time > MIC.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Initial treatment of systemic infections | 25-30 mg/kg | IV, IM or intraosseous | q8-12h | — | 🌎 NA |
| Susceptible infections | 30 mg/kg | IM | q8h | — | 🌍 EU |
| Pseudomonas infections | 30 mg/kg | IM | q2-4h | — | 🌍 EU |
- Susceptible infections: Empirical dose.
- Pseudomonas infections: More frequent dosing recommended for Pseudomonas.
爬蟲類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Susceptible infections | 20 mg/kg | IM or SC | q72hours (every 3 days) | — | 🌎 NA |
| Bacterial infections in snakes (particularly Enterobacteriaceae or Pseudomonas aeruginosa) | 20 mg/kg | IM | q72h | — | 🌎 NA |
| Chelonians | 50 mg/kg | IM | q24h | — | 🌎 NA |
- Bacterial infections in snakes (particularly Enterobacteriaceae or Pseudomonas aeruginosa): Maintain at 30°C
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
頭孢他啶 (Ceftazidime) 是一種強效的第三代頭孢菌素類注射用抗生素，主要用於治療對其他藥物具抗藥性的嚴重革蘭氏陰性菌感染（特別是綠膿桿菌 Pseudomonas aeruginosa）。由於其在爬蟲類體內的半衰期極長，在特寵獸醫學中特別受歡迎，允許較長的給藥間隔（例如每三天一次）。通常以靜脈、肌肉或皮下注射給藥。
作用機制
Ceftazidime is a bactericidal time-dependent antibiotic.
It binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall → inhibits the third and final stage of bacterial cell wall synthesis (peptidoglycan cross-linking) → weakens the cell wall → leads to cell lysis and death due to osmotic instability.
Note: While it retains some gram-positive activity from earlier generations, its primary strength is its expanded gram-negative spectrum, including antipseudomonal activity.
安全性與警告
禁忌症
- Known hypersensitivity or prior allergic reaction to cephalosporins
不良反應
- Pain at IM injection site (SC may be less painful)
- Gastrointestinal effects (diarrhea, vomiting)
- Hypersensitivity reactions (allergic reactions)
- Granulocytopenia
- Thrombocytopenia
- Mild azotemia
- Pseudomembranous colitis (C. difficile)
- Increased serum liver enzymes (reported in humans)
注意事項
Renal Impairment: Because the drug is primarily excreted via the kidneys, accumulation may result in patients with significantly impaired renal function. Use with caution and adjust the dose as required.
- Cross-Reactivity: Up to 16% of humans allergic to penicillins may also be allergic to cephalosporins; the veterinary significance is unclear but warrants caution.
- Laboratory Interference: May cause a false-positive urine glucose determination when using cupric sulfate solution tests (e.g., Clinitest). May rarely cause positive direct Coombs' tests.
藥物相互作用
Potential additive nephrotoxicity. In vitro synergy exists against certain bacteria, but they must NOT be mixed in the same syringe or fluid bag (administer separately).
May be antagonistic to ceftazidime's bactericidal effects on gram-negative bacilli; concurrent use is not recommended.
Bacteriostatic agents may antagonize the bactericidal activity of ceftazidime.
Bacteriostatic agents may antagonize the bactericidal activity of ceftazidime.
Increased risk of nephrotoxicity when used concurrently.
Loop diuretics may increase the risk of nephrotoxicity.
Synergistic in vivo against Pseudomonas; however, chemically incompatible in vitro (do not mix in the same syringe).
監測
- Clinical efficacy (resolution of infection signs)
- Baseline and ongoing renal function (BUN, Creatinine, Urinalysis)
- Injection site for signs of pain or inflammation
藥物動力學
半衰期
吸收
Not appreciably absorbed after oral administration. Must be given parenterally.
分佈
Widely distributed throughout the body, including into bone and cerebrospinal fluid (CSF).
代謝
Not extensively metabolized.
排除
Primarily excreted unchanged by the kidneys via glomerular filtration. Renal tubular excretion does not play a major role (probenecid does not affect elimination kinetics).
過量
An acute overdose in patients with normal renal function is unlikely to be of great concern.
However, in patients with renal failure, overdosage of ceftazidime has caused seizures, encephalopathy, coma, neuromuscular excitability, asterixis, and myoclonia.
Treatment: Primarily symptomatic and supportive. Hemodialysis could be used to enhance elimination.
可用產品
劑型
- Powder for Injection: 500 mg, 1 g, 2 g, 6 g
- Injection (premixed, frozen): 1 g, 2 g
人用標示
- Ceftazidime Powder for Injection: 500 mg, 1 g, 2 g, & 6 g vials (Fortaz, Ceptaz, Tazicef, Tazidime)
- Ceftazidime Injection (premixed, frozen): 1 g & 2 g in 50 mL (Fortaz, Tazicef)
各地核准狀態
Human authorized product used off-label under the Cascade. Classified as a highest priority critically important antibiotic; use is heavily restricted to cases lacking alternatives.
Human authorized product (POM) used off-label under the Cascade. Prudent use guidelines apply.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Powders for injection: Store at 15-30°C (59-86°F) and protect from light. Frozen injection: Store at -20°C (-4°F) or lower. Reconstituted solutions (sodium carbonate formulations) effervesce (release CO2); do not allow pressure to normalize before adding diluent. Reconstituted potency: 24 hours at room temp (18h for arginine formulation), 7 days refrigerated. Frozen in plastic syringes: stable for 3 months at -20°C. Thawed solutions: stable for 8 hours at room temp, 4 days refrigerated. Do not refreeze.
飼主須知
- 給藥方式：您的獸醫可能會指示您在家中為寵物進行皮下注射 (SC)。請確保您了解正確的注射技巧。
- 儲存方式：請嚴格遵守獸醫的儲存指示。如果提供的是冷凍針筒，請保存在冷凍庫中，僅在需要時於室溫下解凍單劑量。解凍後的藥劑請勿再次冷凍。
- 副作用：如果您的寵物出現嚴重的腸胃不適（腹瀉、嘔吐）或過敏反應（如面部腫脹、呼吸困難），請立即聯繫獸醫。
- 注射部位：觀察注射部位是否有紅腫或疼痛的跡象。
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