Rains C P, Bryson H M, Peters D H
Adis International, Auckland, New Zealand.
Drugs. 1995 Apr;49(4):577-617. doi: 10.2165/00003495-199549040-00008.
Ceftazidime is a third generation cephalosporin antibacterial agent which, since its introduction in the early 1980s, has retained a broad spectrum of in vitro antimicrobial activity and clinical utility in serious infections. However, increasing resistance to ceftazidime and other third generation cephalosporins, particularly among Enterobacteriaceae, due to the emergence of plasmid-mediated extended spectrum beta-lactamases and the class I chromosomally mediated beta-lactamases, is of concern. There is now a wealth of information on the pharmacokinetics of the drug. enabling ceftazidime to be used predictably, and with a low potential for adverse effects, in a diversity of patient populations. Overall, ceftazidime remains an effective agent for the treatment of serious infection, particularly those due to major nosocomial pathogens, and respiratory infections in patients with cystic fibrosis. Ceftazidime-containing regimens also remain an important option for the empirical therapy of febrile episodes in neutropenic patients. The tolerability profile of ceftazidime makes the drug a useful option in seriously ill patients who are at risk of developing adverse events with other antibacterial agents. Although patterns of bacterial resistance have changed in the ensuing years since its introduction, judicious use of this important agent will help maintain its present clinical utility.
头孢他啶是一种第三代头孢菌素类抗菌药物，自20世纪80年代初问世以来，在严重感染中一直保持着广泛的体外抗菌活性和临床应用价值。然而，由于质粒介导的超广谱β-内酰胺酶和I类染色体介导的β-内酰胺酶的出现，对头孢他啶和其他第三代头孢菌素的耐药性不断增加，尤其是在肠杆菌科细菌中，这一情况令人担忧。目前已有大量关于该药物药代动力学的信息，使得头孢他啶能够在各种患者群体中可预测地使用，且不良反应的可能性较低。总体而言，头孢他啶仍然是治疗严重感染的有效药物，特别是由主要医院病原体引起的感染以及囊性纤维化患者的呼吸道感染。含头孢他啶的治疗方案仍然是中性粒细胞减少患者发热发作经验性治疗的重要选择。头孢他啶的耐受性使其成为那些使用其他抗菌药物有发生不良事件风险的重症患者的有用选择。尽管自其引入后的数年中细菌耐药模式发生了变化，但明智地使用这一重要药物将有助于维持其目前的临床应用价值。
