Product Details

Ceftizoxime Sodium

A to Z Drug Facts

Ceftizoxime Sodium

Action
Indications
Contraindications
Route/Dosage
Interactions
Lab Test Interferences
Adverse Reactions
PrecautionsPatient Care Considerations
Administration/Storage
Assessment/Interventions
Patient/Family Education

(SEFF-tih-ZOX-eem SO-dee-uhm)CefizoxClass: Antibiotic/cephalosporin

 Action Inhibits mucopeptide synthesis in bacterial cell wall.

 Indications Treatment of infections of lower respiratory tract, urinary tract, skin and skin structures, bone and joint; treatment of intra-abdominal infections, pelvic inflammatory disease, gonorrhea, septicemia and meningitis due to susceptible microorganisms.

 Contraindications Hypersensitivity to cephalosporins.

 Route/Dosage

ADULTS: IV/IM 1–2 g q 8–12 hr (life-threatening infections: IV up to 2 g q 4 hr or 3–4 g q 8 hr). CHILDREN > 6 MO: IV/IM 50 mg/kg q 6–8 hr up to 200 mg/kg/day (maximum 12 g/day).

 Interactions

Aminoglycosides: Increased risk of nephrotoxicity. Probenecid: Inhibition of renal excretion of ceftizoxime. INCOMPATIBILITIES: Aminoglycosides: Do not add aminoglycosides to ceftizoxime solutions because inactivation of both drugs may result; administer at separate sites if concurrent therapy is indicated.

 Lab Test Interferences May cause false-positive urine glucose test results with Benedict's solution, Fehling's solution, or Clinitest tablets but not with enzyme-based tests (eg, Clinistix, Tes-tape); false-positive test results for proteinuria with acid and denaturization-precipitation tests; false-positive direct Coombs' test results in certain patients (eg, those with azotemia); false elevations in urinary 17-ketosteroid values.

 Adverse Reactions

GI: Nausea; vomiting; diarrhea; anorexia; abdominal pain or cramps; flatulence; colitis, including pseudomembranous colitis. GU: Pyuria; renal dysfunction; dysuria; reversible interstitial nephritis; hematuria; toxic nephropathy. HEMA: Eosinophilia; neutropenia; lymphocytosis; leukocytosis; thrombocytopenia; decreased platelet function; anemia; aplastic anemia; hemorrhage. HEPA: Hepatic dysfunction; abnormal liver function test results. OTHER: Hypersensitivity, including Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis; candidal overgrowth; serum sickness—like reactions (eg, skin rashes, polyarthritis, arthralgia, fever); phlebitis; thrombophlebitis and pain at injection site.

 Precautions

Pregnancy: Category B. Lactation: Excreted in breast milk. Children: Safety and efficacy in infants < 6 mo not established. In infants, consider benefits relative to risks. Hypersensitivity: Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients due to possible cross-reactivity. Pseudomembranous colitis: Should be considered in patients who develop diarrhea. Renal impairment: Use drug with caution in patients with baseline renal impairment. Dosage adjustment based on renal function may be required. Superinfection: May result in bacterial or fungal overgrowth of nonsusceptible micro-organisms.

PATIENT CARE CONSIDERATIONS

 

 Administration/Storage

• IV route may be preferable for life-threatening infections.
• Administer after hemodialysis, because drug is partially removed by dialysis.
• When giving by IM route, inject deeply into large muscle (eg, upper outer quadrant of gluteus muscle or lateral thigh); massage well. For amounts > 2 g, divide dose and administer in different muscle masses.
• Reconstituted solution should be light yellow to amber. Do not administer if solution is cloudy or precipitate is present.
• When giving by IV route, administer slowly over 3–5 min using direct (bolus) injection. Change IV sites q 48–72 hr.
• When drug is administered by intermittent IV infusion, reconstituted solution can be further diluted with 50–100 ml of 0.9% Sodium Chloride or D5W and infused over 30 min.
• Completely thaw frozen preparations at room temperature before use. Do not introduce additives. After thawing, solution is stable for 24 hr at room temperature or for 10 days if refrigerated. Do not refreeze.
• Store sterile powder at room temperature and protect from light.
• Reconstituted solution is stable for 96 hr if refrigerated and 24 hr when stored at room temperature.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Note renal impairment and allergy to cephalosporins or penicillins.
• Obtain specimens for culture and sensitivity before beginning therapy and periodically during treatment.
• Monitor renal function carefully during treatment.
• Monitor for signs of infection, especially fever, and for positive response to antibiotic therapy.
• Assess for signs and symptoms of anaphylaxis (shortness of breath, wheezing, laryngeal spasm). Have resuscitation equipment available.
• Assess for signs of superinfection, such as vaginitis or stomatitis.
• Assess for severe diarrhea with blood or pus, which may be symptom of pseudomembranous colitis. Symptoms may occur after antibiotic treatment.
• Monitor IV site for infiltration, infection, thrombophlebitis and bleeding.

OVERDOSAGE: SIGNS & SYMPTOMS Seizures

 Patient/Family Education

• Remind patient to check body temperature daily. If fever persists for more than a few days or if high fever (> 102°F) or shaking chills are noted, physician should be notified immediately.
• Advise patient to maintain normal fluid intake while using this medication.
• Instruct diabetic patient to use enzyme-based tests (eg, Clinistix, Testape) for monitoring urine glucose because drug may give false results with other tests.
• Advise patient to report these symptoms to physician: nausea, vomiting, diarrhea, sore throat, bruising, bleeding, hives, bone or joint pain.
• Instruct patient to report signs of superinfection: black “furry” tongue, white patches in mouth, foul-smelling stools, vaginal itching or discharge.
• Warn patient that diarrhea that contains blood or pus may be a sign of serious disorders. Tell patient to seek medical care and not to treat at home.
• Instruct patient to seek emergency care immediately if wheezing or difficulty in breathing occurs.
• Advise patient to avoid ingesting alcohol.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts