Bégué P
Service de Consultation, Hôpital Trousseau, Paris.
Presse Med. 1988 Oct 26;17(37):1985-7.
Ceftazidime should only be given as "best guess" treatment in infections suspected of being caused by multiresistant bacteria, and notably Pseudomonas aeruginosa. During the last few years, the use of this antibiotic against infections associated with therapeutic bone marrow aplasia or with cystic fibrosis has been thoroughly investigated. As regards neonatal infections, late (hospital-acquired) infections seem to be the best indication. Other major reasons for prescribing ceftazidime are septicaemias in paediatric intensive care units and in surgery, especially when it is feared that P. aeruginosa might emerge. Urinary infection after surgery for complex urinary tract malformations, meningeal infection in neurosurgery, severe otitis media, suspected mastoiditis and otitis of the newborn are special conditions where ceftazidime can be used as first choice therapy. Ceftazidime may be administered alone in certain circumstances, but it is usually given in combination with another antibiotic. In these severe infections, dosage must be high enough to reach the elevated MIC's required by some strains of Pseudomonas.
仅在怀疑由多重耐药菌引起的感染，尤其是铜绿假单胞菌感染时，才应将头孢他啶作为“最佳猜测”治疗药物使用。在过去几年中，已经对这种抗生素用于治疗与治疗性骨髓再生障碍或囊性纤维化相关的感染进行了全面研究。至于新生儿感染，晚期（医院获得性）感染似乎是最佳适应症。开具头孢他啶的其他主要原因是儿科重症监护病房和手术中的败血症，尤其是担心可能出现铜绿假单胞菌时。复杂尿路畸形手术后的尿路感染、神经外科的脑膜感染、严重中耳炎、疑似乳突炎和新生儿中耳炎是可以将头孢他啶用作首选治疗的特殊情况。头孢他啶在某些情况下可以单独给药，但通常与另一种抗生素联合使用。在这些严重感染中，剂量必须足够高，以达到某些铜绿假单胞菌菌株所需的升高的最低抑菌浓度。
