Ceftazidime is generally well-tolerated. The incidence of adverse reactions associated with ceftazidime use was low in clinical trials. The most common were local reactions after IV injection and allergic and GI reactions. No disulfiram-like reactions were reported.
The following adverse effects (AEs) were considered to be either related to ceftazidime therapy or were of uncertain etiology: Local Effects:
Phlebitis or thrombophlebitis with IV administration, pain and/or inflammation at injection site after IM injection (mild to moderate for about 2-5 minutes and subsides within 10-20 minutes); distal necrosis can occur after inadvertent intra-arterial administration of ceftazidime.
Pruritus, rash (maculopapular or erythematous), urticaria, photosensitivity, fever, toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, angioedema, anaphylaxis (bronchospasm and/or hypotension); allergic reactions, which, in rare instances, were severe (e.g., cardiopulmonary arrest).
Diarrhea, nausea, vomiting, abdominal pain, pseudomembranous colitis, metallic taste.
Headache, dizziness, paresthesia; elevated levels of ceftazidime in patients with renal impairment can lead to seizures, convulsions, asterixis, tremor, myoclonia, epilepsy, encephalitis/encephalopathy, neuromuscular excitability, hallucinations and coma.
Transient eosinophilia; reversible thrombocytosis; transient leukopenia, neutropenia, and thrombocytopenia; rare cases of hemolytic anemia, agranulocytosis, and lymphocytosis; positive Coombs' test without hemolysis.
Transient increases in serum concentrations of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, lactate dehydrogenase (LDH), and/or γ-glutamyltransferase (γ-glutamyl transpeptidase, GGT, GGTP); hyperbilirubinemia; hepatitis and/or jaundice.
Transient increases in blood urea, blood urea nitrogen (BUN) and/or serum creatinine concentrations; transient mild to moderate decrease in glomerular filtration; interstitial nephritis; renal failure although a causal relationship to the drug has not been established.
Other Adverse Effects:
Less frequent AEs include candidiasis (oral thrush) and vaginitis; superinfections with organisms resistant to ceftazidime.
In addition to the AEs listed previously which have been observed in patients treated with ceftazidime, the following AEs have been reported for cephalosporin-class antibiotics: Hypersensitivity reactions including chills, joint pain or inflammation, arthralgia, edema, facial edema, erythema, shock, vasodilatation, and exfoliative dermatitis; leukocytosis, granulocytosis, monocytosis, lymphocytopenia, basophilia, decreased hemoglobin and/or hematocrit; aplastic anemia, pancytopenia, epistaxis or hemorrhage, hypoprothrombinemia; colitis, toxic nephropathy, hepatic dysfunction including cholestasis; prolonged prothrombin time, false-positive test for urinary glucose; increased or decreased serum glucose concentration; decreased serum albumin and/or total protein; vaginal candidiasis, menstrual irregularities; dizziness, malaise, fatigue, nightmares, vertigo, hyperactivity, nervousness or anxiety, agitation, sleep disorder/insomnia, somnolence, weakness, hot flushes, alteration in color perception, confusion, and hypertonia; chest pain, pleural effusion, pulmonary infiltrate, dyspnea or respiratory distress, cough, rhinitis.