Understanding Ceftazidime: What is a contraindication for ceftazidime?

October 10, 2025 •

2 min read

Ceftazidime is a third-generation cephalosporin antibiotic used for a number of bacterial infections. A primary concern before administration is identifying contraindications, as hypersensitivity reactions can occur in up to 5% of patients receiving cephalosporin antibiotics. So, what is a contraindication for ceftazidime?

Quick Summary

The main contraindication for ceftazidime is a known hypersensitivity or allergy to ceftazidime or other cephalosporin antibiotics. Caution is also crucial for patients with a history of severe penicillin allergies due to cross-reactivity.

Key Points

Absolute Contraindication: The primary contraindication is a known hypersensitivity (allergy) to ceftazidime or other cephalosporin antibiotics.
Penicillin Allergy: Use with caution in patients with a history of penicillin allergy due to up to a 10% risk of cross-hypersensitivity.
Renal Impairment: Dosage must be reduced for patients with kidney problems to prevent toxic accumulation and severe neurological side effects like seizures.
CDAD Risk: Treatment can lead to Clostridioides difficile-associated diarrhea (CDAD), which can be severe and occur even months after treatment.
Drug Interactions: Ceftazidime can interact with nephrotoxic drugs (e.g., aminoglycosides, furosemide), oral contraceptives, and certain live vaccines.
Neurological Risks: High doses or unadjusted doses in renal failure can cause seizures, encephalopathy, and coma.
Mechanism: Ceftazidime works by inhibiting bacterial cell wall synthesis, leading to the destruction of the bacteria.

Introduction to Ceftazidime

Ceftazidime is a broad-spectrum, semi-synthetic, beta-lactam antibiotic belonging to the third-generation cephalosporin class. It is typically administered by injection (intravenously or intramuscularly) and is used to treat serious bacterial infections by inhibiting bacterial cell wall synthesis. Ceftazidime is effective against infections in various parts of the body and is included on the World Health Organization's List of Essential Medicines.

The Primary Contraindication: Hypersensitivity

The most significant contraindication for ceftazidime is a known history of allergy to ceftazidime or any other cephalosporin antibiotic. Reactions can range from mild rashes to severe anaphylaxis. Due to potential cross-hypersensitivity among beta-lactam antibiotics, extreme caution is necessary for patients with a history of serious penicillin reactions. Healthcare providers must inquire about past drug allergies before prescribing ceftazidime.

Important Warnings and Precautions

Several warnings and precautions should be considered:

Renal Impairment: Since ceftazidime is cleared by the kidneys, dose adjustments are required in patients with impaired renal function to avoid toxic levels and potential neurological issues like seizures or coma.
Clostridioides difficile-Associated Diarrhea (CDAD): Like other antibiotics, ceftazidime can lead to CDAD, which can be severe or even fatal. This can occur during or after treatment.
Gastrointestinal Disease: Caution is advised for patients with a history of GI disease, especially colitis.
Prothrombin Activity: Cephalosporins may affect blood clotting by decreasing prothrombin activity, particularly in at-risk individuals with renal or hepatic issues, poor nutrition, or prolonged antibiotic use.

Drug Interactions of Concern

Ceftazidime can interact with other medications:

Nephrotoxic Agents: Combining ceftazidime with aminoglycosides or potent diuretics may increase the risk of kidney damage. Renal function monitoring is important.
Chloramphenicol: Due to potential antagonistic effects, concurrent use with chloramphenicol should generally be avoided.
Oral Contraceptives: Ceftazidime may reduce the effectiveness of oral contraceptives.
Live Vaccines: Ceftazidime can decrease the efficacy of live bacterial vaccines.

Ceftazidime vs. Cefepime: A Comparison

Both are cephalosporins, but cefepime (4th generation) has a broader spectrum against some bacteria compared to ceftazidime (3rd generation).


Feature	Ceftazidime (3rd Gen)	Cefepime (4th Gen)
Gram-Positive Activity	Moderate.	Superior against Staphylococci and Streptococci.
Gram-Negative Activity	Broad, including Pseudomonas aeruginosa.	Broader, especially against some Enterobacter resistant to ceftazidime.
Resistance Potential	Higher potential for resistance in some bacteria.	Reduced potential for resistance compared to ceftazidime.
Common Dosing Frequency	Typically every 8 hours.	Typically every 12 hours.
Neurotoxicity	Risk of CNS effects, especially in renal impairment.	Similar risk of neurotoxicity.

Conclusion

The main contraindication for ceftazidime is a history of allergy to cephalosporin antibiotics. Caution is also needed for those with severe penicillin allergies, renal impairment, or a history of colitis. Awareness of these factors and potential drug interactions is crucial for safe use. Always provide your healthcare provider with a complete medical history. For more information, refer to authoritative sources such as the FDA.

Frequently Asked Questions

The main reason is a history of a serious allergic reaction (hypersensitivity) to ceftazidime or any other cephalosporin antibiotic.

It depends on the severity of your penicillin allergy. If you've had a severe, anaphylactic reaction to penicillin, ceftazidime should be avoided. For delayed hypersensitivity like a rash, it may be used with caution, but you must inform your doctor as cross-reactivity can occur in up to 10% of patients.

Yes, patients with impaired renal function (creatinine clearance of 50 mL/min or less) require a lower dose or less frequent administration because the drug is cleared by the kidneys.

Serious side effects include severe allergic reactions (anaphylaxis), C. difficile-associated diarrhea, seizures (especially in patients with kidney problems), severe skin reactions like Stevens-Johnson Syndrome, and various blood disorders.

Yes, ceftazidime may reduce the effectiveness of combined oral estrogen/progesterone contraceptives by affecting the gut flora. An alternative or additional form of birth control may be advisable.

Ceftazidime is a Pregnancy Category B drug, meaning animal studies have not shown a risk to the fetus, but there are no adequate studies in pregnant women. It should be used during pregnancy only if clearly needed. It is also excreted in low concentrations in breast milk, so caution should be exercised if breastfeeding.

Ceftazidime is a third-generation cephalosporin, while cefepime is a fourth-generation. Cefepime generally has broader activity against certain Gram-positive bacteria and some ceftazidime-resistant Gram-negative bacteria. Cefepime may also have a lower potential for inducing antibiotic resistance.