Цефтазидим Порошок, флакон, 1 шт, 1 г, для раствора для внутривенного и внутримышечного введения

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Предпочтительно иметь локальные данные по чувствительности особенно при терапии тяжелых инфекций."}},{"type":"header","data":{"text":"Фармакокинетика:","level":3}},{"type":"paragraph","data":{"text":"Всасывание"}},{"type":"paragraph","data":{"text":"После внутримышечного введения цефтазидима в дозе 1 г в плазме быстро достигается максимальная концентрация препарата - 39 мг/л. Через 5 мин после внутривенного болюсного введения препарата в дозе 1 г его плазменная концентрация составляет 87 мг/л."}},{"type":"paragraph","data":{"text":"Распределение"}},{"type":"paragraph","data":{"text":"В плазме сохраняются терапевтически эффективные концентрации цефтазидима через 8-12 часов после внутривенного или внутримышечного введения."}},{"type":"paragraph","data":{"text":"Связь с белками плазмы крови составляет около 10 %."}},{"type":"paragraph","data":{"text":"Концентрации цефтазидима превышающие минимальные ингибирующие концентрации для большинства распространенных патогенных микроорганизмов могут быть достигнуты в костной ткани тканях сердца желчи мокроте синовиальной жидкости внутриглазной жидкости в плевральной и перитонеальной жидкостях. Цефтазидим легко проникает через плаценту и выделяется с грудным молоком. При отсутствии воспалительного процесса в менингеальных оболочках цефтазидим плохо проникает через гематоэнцефалический барьер концентрация препарата в цереброспинальной жидкости (ЦСЖ) низкая. При менингите в ЦСЖ достигаются терапевтические концентрации цефтазидима составляющие 4-20 мг/л и выше."}},{"type":"paragraph","data":{"text":"Метаболизм"}},{"type":"paragraph","data":{"text":"Цефтазидим не метаболизируется в организме."}},{"type":"paragraph","data":{"text":"Выведение"}},{"type":"paragraph","data":{"text":"Период полувыведения около 2 ч. Выводится в неизменном виде почками путем клубочковой фильтрации причем около 80-90 % от введенной дозы выделяется в течение 24 ч. При нарушении функции почек скорость выведения цефтазидима снижается. Менее 1 % препарата выделяется с желчью. У новорожденных продолжительность периода полувыведения больше чем у взрослых в 3-4 раза."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Инфекционно-воспалительные заболевания вызванные чувствительными к цефтазидиму микроорганизмами:"}},{"type":"paragraph","data":{"text":"- тяжелые инфекции включая внутрибольничные (септицемия бактериемия перитонит менингит инфекции у пациентов с иммунодефицитом инфицированные ожоги);"}},{"type":"paragraph","data":{"text":"- инфекции дыхательных путей включая инфекции легких у больных муковисцидозом;"}},{"type":"paragraph","data":{"text":"- инфекции ЛОР органов;"}},{"type":"paragraph","data":{"text":"- инфекции мочевыводящих путей;"}},{"type":"paragraph","data":{"text":"- инфекции кожи и мягких тканей;"}},{"type":"paragraph","data":{"text":"инфекции желудочно-кишечного тракта желчевыводящих путей и брюшной полости;"}},{"type":"paragraph","data":{"text":"- инфекции костей и суставов;"}},{"type":"paragraph","data":{"text":"- инфекции связанные с проведением диализа;"}},{"type":"paragraph","data":{"text":"- профилактика инфекционных осложнений при операциях на предстательной железе (трансуретральная резекция)."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к цефтазидиму или к любому из компонентов препарата; повышенная чувствительность к другим цефалоспоринам в анамнезе; выраженные реакции повышенной чувствительности (например анафилактические реакции) к другим бета-лактамным антибактериальным препаратам в анамнезе."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"У пациентов с нарушением функции почек язвенным колитом в анамнезе; в период новорожденности одновременное применение \"петлевых\" диуретиков и аминогликозидов."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"В течение всей беременности соблюдать осторожность препарат применять только в том случае когда предполагаемая польза для матери превышает потенциальный риск для плода. При применении препарата в период лактации кормление грудью следует прекратить на период лечения."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Дозу препарата устанавливают индивидуально в зависимости от тяжести течения заболевания локализации вида возбудителя и его чувствительности к препарату а также возраста пациента и функции почек. Максимальная суточная доза составляет 6 г. Максимальная суточная доза для взрослых пациентов с муковисцидозом составляет 9 г. Препарат вводят внутривенно (в/в) или внутримышечно (в/м)."}},{"type":"paragraph","data":{"text":"Раствор цефтазидима можно вводить непосредственно в вену или в трубку инфузионной системы. Препарат не следует вводить внутриартериально. При таком пути введения цефтазидима возможно развитие некроза дистальных сегментов конечности."}},{"type":"paragraph","data":{"text":"Взрослым и детям с массой тела более 40 кг: обычно применяют 1 г каждые 8 ч или 2 г каждые 12 ч."}},{"type":"paragraph","data":{"text":"При тяжелых инфекциях особенно у пациентов с иммунодефицитом (включая пациентов с нейтропенией) применяют по 2 г каждые 8 ч или по 3 г каждые 12 ч."}},{"type":"paragraph","data":{"text":"Для лечения инфекционных осложнений при муковисцидозе вызванных Pseudomonasaeruginosa применяют по 100-150 мг/кг/сутки (дробно каждые 8 ч)."}},{"type":"paragraph","data":{"text":"При инфекциях мочевыводящих путей рекомендуется вводить по 1 г каждые 12 ч."}},{"type":"paragraph","data":{"text":"С целью профилактики при операциях на предстательной железе цефтазидим применяют в дозе 1 г во время вводной анестезии и вторую дозу вводят при удалении катетера."}},{"type":"paragraph","data":{"text":"Детский возраст до 2 месяцев: применяют по 25-60 мг/кг/сутки (дробно каждые 12 ч)."}},{"type":"paragraph","data":{"text":"Детям старше 2 месяцев и до 12 лет: применяют по 30-100 мг/кг/сутки (дробно каждые 8-12 ч)."}},{"type":"paragraph","data":{"text":"У детей с иммунодефицитом муковисцидозом и менингитом применяют 150 мг/кг/сутки (максимально 6 г/сутки) (дробно каждые 8 ч)."}},{"type":"paragraph","data":{"text":"Пациентам пожилого возраста: рекомендованная доза цефтазидима не должна превышать 3 г/сутки особенно у пациентов старше 80 лет."}},{"type":"paragraph","data":{"text":"Пациентам с нарушением функции почек (взрослые и дети с массой тела более 40 кг): начальная доза 1 г. Поддерживающую дозу подбирают в зависимости от скорости выделения креатинина: при клиренсе креатинина (КК) 50-31 мл/мин - 1 г каждые 12 ч 30-16 мл/мин - 1 г каждые 24 ч 15-6 мл/мин - 05 г каждые 24 ч менее 5 мл/мин - 05 г каждые 48 часов."}},{"type":"paragraph","data":{"text":"Пациентам с инфекциями тяжелого течения разовую дозу можно увеличить на 50 % или увеличить частоту введения препарата при этом следует контролировать концентрацию цефтазидима в сыворотке крови (не должна превышать 40 мг/мл)."}},{"type":"paragraph","data":{"text":"Для детей клиренс креатинина рассчитывается в соответствии с идеальной массой тела или площадью поверхности тела."}},{"type":"paragraph","data":{"text":"Пациентам с нарушением функции почек (дети с массой тела менее 40 кг): поддерживающая доза при клиренсе креатинина 50-31 мл/мин - 25 мг/кг каждые 12 ч при клиренсе креатинина 30-16 мл/мин - 25 мг/кг каждые 24 ч при клиренсе креатинина 15-6 мл/мин - 12.5 мг/кг каждые 24 ч при клиренсе креатинина менее 5 мл/мин - 12.5 мг/кг каждые 48 ч."}},{"type":"paragraph","data":{"text":"На фоне гемодиализа поддерживающие дозы рассчитывают с учетом клиренса креатинина введение проводят после каждого сеанса гемодиализа. На фоне перитонеального диализа помимо внутривенного введения цефтазидим можно включать в диализный раствор (125-250 мг на 2 л диализного раствора). У пациентов с почечной недостаточностью находящихся на непрерывном гемодиализе с использованием артериовенозного шунта и у пациентов находящихся на гемофильтрации высокой скорости в отделении интенсивной терапии рекомендуемые дозы - 1 г/сут ежедневно (за одно или несколько введений)."}},{"type":"paragraph","data":{"text":"У пациентов находящихся на гемофильтрации низкой скорости применяют дозы рекомендуемые при нарушении функции почек."}},{"type":"paragraph","data":{"text":"У пациентов находящихся на перитонеальном диализе вводится 05 г препарата каждые 24 часа."}},{"type":"paragraph","data":{"text":"У пациентов на гемофильтрации с применением вено-венозного шунта и на непрерывном гемодиализе с применением вено-венозного шунта - в соответствии с представленными в таблицах 1-2 данными."}},{"type":"paragraph","data":{"text":"Пациентам с нарушением функции печени: согласно имеющимся данным нет необходимости в коррекции режима дозирования у пациентов с легкой и средней степени тяжести нарушениями функции печени. Отсутствуют результаты исследований у пациентов с нарушением функции печени тяжелой степени. Рекомендуется тщательный клинический мониторинг безопасности и эффективности."}},{"type":"paragraph","data":{"text":"Продолжительность лечения цефтазидимом составляет 7-14 дней. При инфекциях вызванных Pseudomonasaeruginosa (пневмония муковисцидоз менингит) курс лечения может быть увеличен до 21 дня."}},{"type":"paragraph","data":{"text":"Правила приготовления и введения растворов"}},{"type":"paragraph","data":{"text":"Следует использовать только свежеприготовленные растворы. После добавления растворителя флакон необходимо энергично встряхивать до полного растворения порошка. \"Первичное разведение\": для внутримышечного введения 1 г цефтазидима растворяют в 3 мл воды для инъекций."}},{"type":"paragraph","data":{"text":"Взрослым и детям старше 12 лет для уменьшения боли при в/м инъекциях препарат следует вводить с 1 % раствором лидокаина. Вводят глубоко в ягодичную мышцу или в мышцу бедра. Не следует вводить более 1 г цефтазидима в одну мышцу. Раствор лидокаина нельзя вводить внутривенно!"}},{"type":"paragraph","data":{"text":"Для внутривенного введения 1 г растворяют в 10 мл воды для инъекций. Раствор вводят в течение 2-4 мин."}},{"type":"paragraph","data":{"text":"\"Вторичное разведение\": для внутривенного капельного введения полученный вышеописанным способом раствор препарата переносят в систему для инфузий и доводят общий объем как минимум до 50 мл одним из следующих растворителей предназначенных для в/в введения: 09 % раствор натрия хлорида раствор Рингера раствор Рингера лактат 5 % раствор декстрозы 5 % раствор декстрозы с 09 % раствором натрия хлорида 10 % раствор декстрозы."}},{"type":"paragraph","data":{"text":"Можно применять только свежеприготовленный раствор."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Аллергические реакции: макулопапулезная сыпь кожный зуд лихорадка крапивница ангионевротический отек анафилактические реакции (бронхоспазм снижение артериального давления) анафилактический шок мультиформная экссудативная эритема (в том числе синдром Стивенса-Джонсона) синдром Лайелла эозинофилия."}},{"type":"paragraph","data":{"text":"Со стороны нервной системы: головная боль головокружение парестезии неприятный вкус во рту. У больных с нарушением функции почек при неправильном подборе дозы - судороги энцефалопатия \"порхающий\" тремор кома миоклония."}},{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: диарея тошнота рвота боль в животе холестаз желтуха псевдомембранозный колит орофарингеальный кандидоз."}},{"type":"paragraph","data":{"text":"Со стороны системы кроветворения: гемолитическая анемия лейкопения нейтропения лимфоцитоз тромбоцитопения геморрагии агранулоцитоз."}},{"type":"paragraph","data":{"text":"Со стороны половой системы: кандидоз влагалища вагинит."}},{"type":"paragraph","data":{"text":"Со стороны мочевыделительной системы: нарушение функции почек интерстициальный нефрит острая почечная недостаточность."}},{"type":"paragraph","data":{"text":"Местные- реакции: при в/в введении - тромбофлебит в месте введения флебит болезненность уплотнение по ходу вены; при в/м введении - болезненность жжение воспаление уплотнение в месте введения."}},{"type":"paragraph","data":{"text":"Лабораторные показатели: увеличение протромбинового времени повышение концентрации азота и/или креатинина в крови повышение активности \"печеночных\" трансаминаз и щелочной фосфатазы повышение активности лактатдегидрогеназы гамма- глутамилтранспептидазы гипербилирубинемия повышение концентрации мочевины ложноположительная реакция мочи на глюкозу ложноположительная прямая реакция Кумбса без гемолиза панцитопения тромбоцитоз."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Чаще возникает у больных с почечной недостаточностью."}},{"type":"paragraph","data":{"text":"Симптомы: неврологические нарушения с развитием энцефалопатии судорог и комы головокружение головная боль. Отклонение в результатах лабораторных анализов (увеличение содержания мочевины и сывороточного креатинина в крови гипербилирубинемия тромбоцитоз тромбоцитопения эозинофилия лейкопения удлинение протромбинового времени) у пациентов с почечной недостаточностью - судороги энцефалопатия \"порхающий\" тремор кома нейромышечная возбудимость. Передозировка цефтазидимом может вызвать боль воспаление флебит в месте инфузии."}},{"type":"paragraph","data":{"text":"Лечение: специфический антидот отсутствует. Лечение симптоматическое поддерживающее также необходимы мероприятия направленные на контроль судорог. У больных с нарушением функции почек а также в случае тяжелой передозировки когда консервативная терапия безуспешна концентрация цефтазидима в крови может быть уменьшена при помощи перитонеального диализа или гемодиализа."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Фармацевтически несовместим с аминогликозидами (значительная взаимная инактивация: при одновременном применении эти препараты следует вводить в разные вены или участки тела при внутримышечном введении) ванкомицином (образует осадок в зависимости от концентрации при необходимости вводить два препарата через одну трубку между их применением системы для внутривенного введения следует промыть) и хлорамфениколом. Нельзя использовать раствор натрия гидрокарбоната в качестве растворителя (образуется углерода диоксид)."}},{"type":"paragraph","data":{"text":"\"Петлевые\" диуретики аминогликозиды ванкомицин клиндамицин снижают клиренс креатинина в результате чего возрастает риск нефротоксического действия цефтазидима. Бактериостатические антибиотики (в том числе хлорамфеникол) снижают эффективность цефтазидима."}},{"type":"paragraph","data":{"text":"Возможно взаимодействие препарата с пероральными контрацептивами - снижение эффективности контрацепции."}},{"type":"paragraph","data":{"text":"При совместном применении возможно увеличение нефротоксичности препаратов фуросемида и аминогликозидных антибиотиков."}},{"type":"paragraph","data":{"text":"Фармацевтически совместим со следующими растворами: при концентрации от 1 до 40 мг/мл - 09 % раствором натрия хлорида; раствором натрия лактата; раствором Хартмана; 5 % раствором декстрозы; 0225 % раствором натрия хлорида и 5 % раствором декстрозы; 045 % раствором натрия хлорида и 5 % раствором декстрозы; 018 % раствором натрия хлорида и 4 % раствором декстрозы; 10 % раствором декстрозы; 10 % раствором декстрана с молекулярной массой около 40 тысяч Дальтон в 09 % растворе натрия хлорида или в 5 % растворе декстрозы; 6 % раствором декстрана с молекулярной массой около 70 тысяч Дальтон в 09 % растворе натрия хлорида или в 5 % растворе декстрозы."}},{"type":"paragraph","data":{"text":"В концентрациях от 005 до 025 мг/мл цефтазидим совместим с раствором для интраперитонеального диализа (лактат)."}},{"type":"paragraph","data":{"text":"Для внутримышечного введения цефтазидим может быть разведен 05 - 1 % раствором лидокаина гидрохлорида. Оба компонента сохраняют активность если цефтазидим в концентрации 4 мг/мл добавляют к следующим растворам: гидрокортизона (гидрокортизона натрия фосфат) 1 мг/мл в 09 % растворе натрия хлорида или в 5 % растворе декстрозы; цефуроксима (цефуроксим натрия) 3 мг/мл в 09 % растворе натрия хлорида; клоксациллина (клоксациллин натрия) 4 мг/мл в 09 % растворе натрия хлорида; гепарина 10 МЕ/мл или 50 МЕ/мл в 09 % растворе натрия хлорида; калия хлорида 10 мЭк/л или 40 мЭк/л в 09 % растворе натрия хлорида."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"В случае тяжелых или жизнеугрожающих инфекций особенно у пациентов с иммунодефицитом (включая пациентов с нейтропенией) препарат можно применять с другими антибиотиками такими как аминогликозиды ванкомицин и клиндамицин при условии раздельного введения."}},{"type":"paragraph","data":{"text":"Пациенты имевшие в анамнезе аллергические реакции на цефалоспорины пенициллины и другие бета-лактамные антибактериальные препараты могут иметь повышенную чувствительность к цефалоспориновым антибиотикам. При развитии аллергической реакции в ответ на прием цефтазидима препарат следует немедленно отменить. В тяжелых случаях острых форм гиперчувствительности может потребоваться введение эпинефрина и экстренное проведение других терапевтических мероприятий включая оксигенотерапию инфузионную терапию введение глюкокортикостероидов прессорных аминов восстановление проходимости дыхательных путей в соответствии с клиническими показаниями."}},{"type":"paragraph","data":{"text":"Цефтазидим следует назначать с осторожностью пациентам имеющим в анамнезе указания на заболевания желудочно-кишечного тракта в особенности воспалительные заболевания толстой кишки. Возможно развитие диареи при применении антибиотиков в том числе цефтазидима. В некоторых случаях на фоне приема препарата или после его окончания у пациентов может развиться водянистый или кровавый стул (который может сопровождаться спастическими абдоминальными болями и лихорадкой). У некоторых пациентов во время или после применения цефтазидима может развиваться псевдомембранозный колит вызываемый токсинами вырабатываемыми Clostridiumdifficile. Поэтому важно учитывать возможность развития псевдомембранозного колита у пациентов с диареей во время или после применения препарата. В этом случае прекращают терапию цефтазидимом и назначают терапию псевдомембранозного колита в соответствии с клинической картиной. Препараты тормозящие перистальтику кишечника противопоказаны."}},{"type":"paragraph","data":{"text":"При лечении цефтазидимом у некоторых первоначально чувствительных штаммов Enterobacterspp. и Serratiaspp. может развиваться резистентность поэтому при лечении инфекций вызванных этими микроорганизмами следует периодически проводить исследование на чувствительность к антибиотикам."}},{"type":"paragraph","data":{"text":"Назначение цефтазидима в отсутствие веских подозрений или подтверждения бактериальной этиологии воспалительных изменений а также его назначение в профилактических целях приводит к увеличению вероятности появления штаммов резистентных к цефтазидиму при этом клиническая польза от применения сомнительна."}},{"type":"paragraph","data":{"text":"Препарат может препятствовать синтезу витамина К вследствие подавления кишечной микрофлоры что может вызвать снижение зависимых от витамина К факторов свертывания крови и в редких случаях привести к гипопротромбинемии и кровотечению. Назначение витамина К быстро устраняет гипопротромбинемию. Риск развития кровотечений наиболее' высок у пациентов с тяжелым течением заболевания у пациентов с нарушением функции печени у пожилых и ослабленных больных у лиц с неполноценным питанием."}},{"type":"paragraph","data":{"text":"При нарушении функции почек рекомендуется снижение дозы препарата."}},{"type":"paragraph","data":{"text":"Для-пожилых пациентов целесообразно во время лечения контролировать функцию почек. При одновременном применении с препаратами которые могут оказывать нефротоксическое действие такими как аминогликозидные антибиотики и диуретики (например фуросемид) следует контролировать функцию почек. Пациентам с острой и хронической почечной недостаточностью необходима коррекция дозы цефтазидима ввиду риска развития клинически значимых нарушений например судорог (см. раздел \" Способ применения и дозы\")."}},{"type":"paragraph","data":{"text":"При проведении длительного курса терапии цефтазидимом рекомендуется регулярно выполнять анализ крови с целью оценки показателей функции печени и почек."}},{"type":"paragraph","data":{"text":"В период применения цефтазидима возможна положительная прямая реакция Кумбса и ложноположительная реакция мочи на глюкозу при использовании раствора Бенедикта и Фелинга. На фоне терапии цефтазидимом рекомендуется для определения глюкозы в моче использовать тесты основанные на реакциях ферментативного окисления глюкозы."}},{"type":"paragraph","data":{"text":"Во время лечения нельзя употреблять этанол из-за возможности развития дисульфирамоподобных реакций (внезапный \"прилив\" крови к лицу спастические боли в животе тошнота рвота головная боль тахикардия одышка)."}},{"type":"paragraph","data":{"text":"Во флаконе на 10 г цефтазидима содержится 50 мг натрия. Данную информацию необходимо принимать во внимание при применении препарата у пациентов придерживающихся диеты с ограничением потребления натрия."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"В период лечения необходимо соблюдать осторожность при управлении транспортными средствами и занятиями другими потенциально опасными видами деятельности требующими повышенной концентрации внимания и быстроты психомоторных реакций. Пациенты должны быть предупреждены о возможности развития головокружения судорог. При появлении описанных нежелательных явлений следует воздержаться от выполнения указанных видов деятельности."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Порошок для приготовления раствора для внутривенного и внутримышечного введения 10 г."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В сухом защищенном от света месте при температуре не выше 25 °C."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года. Не использовать по истечении срока годности."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Акционерное Общество \"Рафарма\" (АО \"Рафарма\"), 399540, Липецкая обл., Тербунский район, поселение Тербунский с/с, с. Тербуны, ул. Дорожная, д. 6А, Россия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"АО \"Рафарма\""}}]}],"source":null},"description_toggle":false,"short_description":"Цефтазидим является цефалоспориновым антибиотиком III поколения. Бактерицидная активность обусловлена подавлением синтеза клеточной стенки бактерий. Широкий спектр патогенных возбудителей чувствителен к цефтазидиму включая штаммы резистентные к другими цефалоспоринам и ампициллину. Цефтазидим устойчив к действию большинства 0-лактамаз грамположительных и грамотрицательных бактерий. Ниже приведена активность цефтазидима in vitro. Бактерии обычно чувствительные к цефтазидиму: Грамположительные аэробы: бета-гемолитические стрептококки1Staphylococcus aureus (штаммы чувствительные к метициллину)1Staphylococcusspp. коагулазонегативные (штаммы чувствительные к метициллину). Грамотрицательные аэробы: Haemophilus influenzae (включая штаммы устойчивые к ампициллину)1Haemophilus parainfluenzae Neisseria gonorrhoeae Neisseria meningitidis1Pasteurella multocida Proteus spp.1Providencia spp. Salmonella spp. Shigella spp. Бактерии для которых вероятна приобретенная резистентность к цефтазидиму: Грамположительные аэробы: Streptococcus pneumoniae1Streptococcusspp. группы Viridans. Грамотрицательные аэробы: Acinetobacter spp. Burkholderia cepacia Citrobacter spp.1Enterobacter spp.1Escherichia coli Klebsiella spp. в том числе Klebsiella pneumoniae1Morganella morganii Pseudomonas spp. в том числе Pseudomonas aeruginosa1Serratia spp.1Yersinia enterocolitica. Грамположительные анаэробы: Clostridium spp. не включая Clostridium difficile Peptostreptococcus spp. Propionibacterum spp. Грамотрицательные анаэробы: Fusobacterium spp. Бактерии обладающие природной устойчивостью к цефтазидиму: Грамположительные аэробы: Enterococcus spp. включая Enterococcus faecalis и Enterococcusfaecium Listeria spp. Грамотрицательные аэробы: Campylobacter spp. Грамположительные анаэробы: Clostridium difficile. Грамотрицательные анаэробы: Bacteroides spp. включая Bacteroides fragilis. Прочие: Chlamydia spp. Legionella spp Mycoplasma spp.1для данных бактерий клиническая эффективность цефтазидима была продемонстрирована в клинических исследованиях. Распространенность приобретенной резистентности к цефтазидиму варьируется в зависимости от региона и с течением времени у определенных видов микроорганизмов устойчивость может быть очень высокой. Предпочтительно иметь локальные данные по чувствительности особенно при терапии тяжелых инфекций. Всасывание После внутримышечного введения цефтазидима в дозе 1 г в плазме быстро достигается максимальная концентрация препарата - 39 мг/л. Через 5 мин после внутривенного болюсного введения препарата в дозе 1 г его плазменная концентрация составляет 87 мг/л. Распределение В плазме сохраняются терапевтически эффективные концентрации цефтазидима через 8-12 часов после внутривенного или внутримышечного введения. Связь с белками плазмы крови составляет около 10 %. Концентрации цефтазидима превышающие минимальные ингибирующие концентрации для большинства распространенных патогенных микроорганизмов могут быть достигнуты в костной ткани тканях сердца желчи мокроте синовиальной жидкости внутриглазной жидкости в плевральной и перитонеальной жидкостях. Цефтазидим легко проникает через плаценту и выделяется с грудным молоком. При отсутствии воспалительного процесса в менингеальных оболочках цефтазидим плохо проникает через гематоэнцефалический барьер концентрация препарата в цереброспинальной жидкости (ЦСЖ) низкая. При менингите в ЦСЖ достигаются терапевтические концентрации цефтазидима составляющие 4-20 мг/л и выше. Метаболизм Цефтазидим не метаболизируется в организме. Выведение Период полувыведения около 2 ч. Выводится в неизменном виде почками путем клубочковой фильтрации причем около 80-90 % от введенной дозы выделяется в течение 24 ч. При нарушении функции почек скорость выведения цефтазидима снижается. Менее 1 % препарата выделяется с желчью. 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