Utazid

Description

Utazid Injection 1 gm, containing ceftazidime, is a broad-spectrum cephalosporin antibiotic used in Pakistan to treat serious bacterial infections. Produced by Bosch Pharmaceuticals, it’s administered in hospitals for conditions like meningitis, septicemia, and pneumonia, targeting resistant bacteria common in high-pollution areas like Karachi or hospital settings in Rawalpindi. Available as a single vial, it’s prescription-only, priced around Rs. 240 per vial, widely stocked in DRAP-registered pharmacies.

How It Functions

Ceftazidime disrupts bacterial cell wall synthesis by binding to penicillin-binding proteins, causing cell lysis, particularly effective against gram-negative bacteria like Pseudomonas aeruginosa and some gram-positive strains. Chemically, it’s (6R,7R)-7-[[(2Z)-2-(2-amino-1,3-thiazol-4-yl)-2-(2-carboxypropan-2-yloxyimino)acetyl]amino]-8-oxo-3-(pyridin-1-ium-1-ylmethyl)-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate pentahydrate. Peak effect occurs within 1 hour post-injection, lasting 3-6 hours.

Dosage Information

Administered via IV or IM by healthcare professionals:

• Adults: 1-6 gm/day in 2-3 divided doses (e.g., 2 gm every 8 hours for meningitis, septicemia, or bone infections).
• Children (1 month-12 years): 30-50 mg/kg/day in 2-3 doses, up to 6 gm/day.
• Neonates (0-4 weeks): 30 mg/kg every 12 hours.
• IV: Bolus over 3-5 minutes or infusion over 15-30 minutes; reconstitute 1 gm with 10 ml SWFI, D5W, or NaCl, dilute further in 50-100 ml for infusion.
• IM: Reconstitute with 3 ml SWFI or bacteriostatic water. Rotate IV sites every 72 hours; check for phlebitis.

Side Effects

• Very Common (>1 in 10): Abdominal pain, bloating, diarrhea, fever, injection site swelling/redness, white patches in mouth/tongue.
• Common (up to 1 in 10): Pain at injection site, nausea, vomiting, candidiasis, eosinophilia, neutropenia, leucopenia, thrombocytopenia, elevated liver enzymes, blood urea rise, positive Coombs’ test.
• Rare: Dizziness, fast heartbeat, headache, skin rash, yellowing eyes/skin, phlebitis, thrombophlebitis, thrombocytosis, pseudomembranous colitis, hemolytic anemia.

Drug Interactions

Ceftazidime may interact with:

• Amikacin: Increases kidney toxicity risk.
• Ethinyl estradiol: Reduces contraceptive efficacy.
• Cholera vaccine: Decreases vaccine response.
• Furosemide: Enhances kidney strain.
• Cyclosporine: Raises nephrotoxicity risk.

Indications

Approved for treating:

• Bacterial meningitis (e.g., Streptococcus pneumoniae, Neisseria meningitidis).
• Septicemia (e.g., Staphylococci, Streptococcus pyogenes).
• Intra-abdominal infections (e.g., Helicobacter pylori, Streptococci).
• Pneumonia (e.g., Streptococcus pneumoniae, Haemophilus influenzae).
• Bone/joint infections (e.g., septic arthritis, osteomyelitis).
• Pyelonephritis (e.g., E. coli, Pseudomonas aeruginosa).

When Not to Use

Avoid in:

• Hypersensitivity to ceftazidime, cephalosporins, penicillins, or beta-lactam antibiotics.
• Severe kidney failure without dose adjustment.
• History of severe allergic reactions (e.g., anaphylaxis).

Precautions

• Monitor for allergic reactions; rash or swelling needs immediate attention.
• Use cautiously in kidney disease; adjust dose based on creatinine clearance.
• Watch for severe diarrhea, which may signal Clostridium difficile infection.
• Pregnancy/breastfeeding: Use only if benefits outweigh risks; small amounts in breast milk may cause diarrhea or thrush in infants.
• Ensure proper reconstitution; discard if particulate matter visible.
• Buy from DRAP-registered pharmacies; check holograms to avoid counterfeits.

Warnings

• Allergy: Risk of cross-reactivity with penicillins; stop if rash, swelling, or breathing issues occur.
• Drug resistance: Avoid without confirmed bacterial infection to prevent resistant strains.
• Kidney function: Monitor closely; high doses in renal impairment may cause seizures or encephalopathy.
• Gastrointestinal: Severe diarrhea or blood in stools requires stopping and medical review.
• Seizure risk: Higher in kidney disease or epilepsy history; adjust dose or use anticonvulsants if needed.

Additional Notes

• Pregnancy Category: Consult physician; limited data suggests use only if essential.
• Breastfeeding: Small amounts excreted; monitor infant for diarrhea or thrush.
• Availability: Common in urban hospitals and pharmacies; alternatives like Zitum or Zipenta available.
• Stability: Reconstituted solution stable for 24 hours at room temperature, 10 days refrigerated, 12 weeks frozen.
• Reporting: Log batch for side effects; report to DRAP for quality control.

Doctor Review

Infectious disease specialists in Pakistan note Utazid’s strength against resistant gram-negative infections, vital in ICU settings or for post-surgical infections in cities like Peshawar. DRAP data supports its efficacy in severe cases like meningitis, but doctors emphasize kidney function tests to avoid toxicity, especially in dehydrated patients.

Disclaimer

This is general product information, not a prescription or medical advice. Consult your doctor or pharmacist for personal guidance.