Ceftazidime in septicaemia

Abstract

Thirty-five patients with mean age 70 years (range 22 to 92) with 37 proven episodes of septicaemia (26) or bacteraemia (11) were treated with a mean ceftazidime dose of 1.80 (range 1 to 2 g) bid for 12 (range 3 to 17) days. Twenty patients had underlying diseases. Escherichia coli was the most common pathogen (19/37). Of the 37 strains 36 were tested for antibiotic sensitivity and 35 were fully sensitive with MIC less than or equal to 8 mg/l (21 less than or equal to 0.12 mg/l). The remaining strain, a Staphylococcus aureus, was moderately susceptible (MIC 16 mg/l). Thirty patients (81%) were cured, six improved and one considered not evaluable. Serum concentrations were studied in 12 patients with slightly or moderately impaired renal function. They had trough and peak values ranging from less than or equal to 1.0 to 118.4 mg/l and 30 to 246.4 mg/l, respectively. In three patients the initial dose of 2 g bid had to be reduced to 1 g bid due to very high trough levels, and due to low peak value in one patient the dose was increased from 1 g to 2 g bid. Adverse reactions were mostly mild (positive Coombs' reaction, transiently raised aminotransferases or raised serum creatinine). Treatment had to be stopped in two cases due to drug fever and/or rash. Therapy with ceftazidime 2 g bid seems to be successful in Gram-negative septicaemia; however, in patients with decreased renal function serum concentrations should be determined.