Ceftizoxime Sodium — Active Pharmaceutical Ingredient

Ceftizoxime Sodium (3 brand names, 1 dosage form, 1 route)

Available dosage forms: INJECTABLE.

Routes of administration: INJECTION.

Brand Names

• CEFIZOX
• CEFIZOX IN DEXTROSE 5% IN PLASTIC CONTAINER
• CEFIZOX IN PLASTIC CONTAINER

Related Health Topics

• Sodium

Indications and Usage

Cefizox (ceftizoxime for injection, USP) is indicated in the treatment of infections due to susceptible strains of the microorganisms listed below.Lower Respiratory Tract Infections caused by Klebsiella spp.; Proteus mirabilis; Escherichia coli; Haemophilus influenzae including ampicillin­resistant strains; Staphylococcus aureus (penicillinase­ and nonpenicillinase­producing); Serratia spp.; Enterobacter spp.; Bacteroides spp.; and Streptococcus spp. including S. pneumoniae, but excluding enterococci.Urinary Tract Infections caused by Staphylococcus aureus (penicillinase­ and nonpenicillinase­producing); Escherichia coli; Pseudomonas spp. including P.aeruginosa; Proteus mirabilis; P. vulgaris; Providencia rettgeri (formerly Proteus rettgeri) and Morganella morganii (formerly Proteus morganii); Klebsiella spp.; Serratia spp. including S. marcescens; and Enterobacter spp.Gonorrhea including uncomplicated cervical and urethral gonorrhea caused by Neisseria gonorrhoeae.Pelvic Inflammatory Disease caused by Neisseria gonorrhoeae, Escherichia coli or Streptococcus agalactiae. NOTE: Ceftizoxime, like other cephalosporins, has no activity against Chlamydia trachomatis. Therefore, when cephalosporins are used in the treatment of patients with pelvic inflammatory disease and C. trachomatis is one of the suspected pathogens, appropriate anti­chlamydial coverage should be added.Intra­Abdominal Infections caused by Escherichia coli; Staphylococcusepidermidis; Streptococcus spp. (excluding enterococci); Enterobacter spp.; Klebsiella spp.; Bacteroides spp. including B. fragilis; and anaerobic cocci, including Peptococcus spp. and Peptostreptococcus spp.Septicemia caused by Streptococcus spp. including S. pneumoniae (but excluding enterococci); Staphylococcus aureus (penicillinase­ and nonpenicillinase­producing); Escherichia coli; Bacteroides spp. including B. fragilis; Klebsiella spp.; and Serratia spp.Skin and Skin Structure Infections caused by Staphylococcus aureus (penicillin

Dosage and Administration

The usual adult dosage is 1 or 2 grams of Cefizox (ceftizoxime for injection, USP) every 8 to 12 hours. Proper dosage and route of administration should be determined by the condition of the patient, severity of the infection, and susceptibility of the causative organisms.General Guidelines for Dosage of Cefizox Type ofInfectionDaily Dose(Grams)Frequencyand Route Uncomplicated Urinary Tract1500 mg q12h IM or IV Other Sites2-31 gram q8-12h IM or IV Severe or Refractory3-61 gram q8h IM or IV2 grams q8-12h IMWhen administering 2 gram IM doses, the dose should be divided and given in different large muscle masses. or IV PIDIf C. trachomatis is a suspected pathogen, appropriate anti­chlamydial coverage should be added, because ceftizoxime has no activity against this organism.62 grams q8h IV Life-Threatening In life­threatening infections, dosages up to 2 grams every 4 hours have been given.9-123-4 grams q8h IV ______________________________________________________________________________Because of the serious nature of urinary tract infections due to P. aeruginosa and because many strains of Pseudomonas species are only moderately susceptible to Cefizox, higher dosage is recommended. Other therapy should be instituted if the response is not prompt. A single, 1 gram IM dose is the usual dose for treatment of uncomplicated gonorrhea.The IV route may be preferable for patients with bacterial septicemia, localized parenchymal abscesses (such as intra­abdominal abscess), peritonitis, or other severe or life­threatening infections.In those with normal renal function, the IV dosage for such infections is 2 to 12 grams of Cefizox (ceftizoxime for injection, USP) daily. In conditions such as bacterial septicemia, 6 to 12 grams/day may be given initially by the IV route for several days, and the dosage may then be gradually reduced according to clinical response and laboratory findings.Pediatric Dosage Schedule Unit DoseFrequency Pediatric patients6 months or older50 mg/kgq6-8h D

Contraindications

Cefizox (ceftizoxime for injection, USP) is contraindicated in patients who have known allergy to the drug.

Adverse Reactions

Cefizox® (ceftizoxime for injection, USP) is generally well tolerated. The most frequent adverse reactions (greater than 1% but less than 5%) are:Hypersensitivity–Rash, pruritus, fever.Hepatic–Transient elevation in AST (SGOT), ALT (SGPT), and alkaline phosphatase.Hematologic–Transient eosinophilia, thrombocytosis. Some individuals have developed a positive Coombs test.Local–Injection site–Burning, cellulitis, phlebitis with IV administration, pain, induration, tenderness, paresthesia.The less frequent adverse reactions (less than 1%) are:Hypersensitivity–Numbness and anaphylaxis have been reported rarely.Hepatic–Elevation of bilirubin has been reported rarely.Renal–Transient elevations of BUN and creatinine have been occasionally observed with Cefizox.Hematologic–Anemia, including hemolytic anemia with occasional fatal outcome, leukopenia, neutropenia, and thrombocytopenia have been reported rarely.Urogenital–Vaginitis has occurred rarely.Gastrointestinal–Diarrhea; nausea and vomiting have been reported occasionally.Symptoms of pseudomembranous colitis can appear during or after antibiotic treatment (see WARNINGS).In addition to the adverse reactions listed above which have been observed in patients treated with ceftizoxime, the following adverse reactions and altered laboratory tests have been reported for cephalosporin­class antibiotics:Stevens­Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, serum­sickness like reaction, toxic nephropathy, aplastic anemia, hemorrhage, prolonged prothrombin time, elevated LDH, pancytopenia, and agranulocytosis.Several cephalosporins have been implicated in triggering seizures, particularly in patients with renal impairment, when the dosage was not reduced. (See DOSAGE AND ADMINISTRATION.) If seizures associated with drug therapy occur, the drug should be discontinued. Anticonvulsant therapy can be given if clinically indicated.

Drug Interactions

Although the occurrence has not been reported with Cefizox, nephrotoxicity has been reported following concomitant administration of other cephalosporins and aminoglycosides.