Ceftizoxime indications and usage

# Indications and Usage
Cefizox (ceftizoxime injection) is indicated in the treatment of infections due to susceptible strains of the microorganisms listed below.

### Lower Respiratory Tract Infections
- Klebsiella spp.
- Proteus mirabilis
- Escherichia coli
- Haemophilus influenzae including ampicillinresistant strains
- Staphylococcus aureus (penicillinase and nonpenicillinaseproducing)
- Serratia spp.
- Enterobacter spp.
- Bacteroides spp.
- Streptococcus spp. including S. pneumoniae, but excluding enterococci.

### Urinary Tract Infections
- Staphylococcus aureus (penicillinase and nonpenicillinaseproducing)
- Escherichia coli
- Pseudomonas spp. including P. aeruginosa
- Proteus mirabilis
- P. vulgaris
- Providencia rettgeri (formerly Proteus rettgeri)
- Morganella morganii (formerly Proteus morganii)
- Klebsiella spp.
- Serratia spp. including S. marcescens
- Enterobacter spp.

### Gonorrhea
- Uncomplicated cervical and urethral gonorrhea caused by Neisseria gonorrhoeae.

### Pelvic Inflammatory Disease
- Neisseria gonorrhoeae
- Escherichia coli or Streptococcus agalactiae.
NOTE: Ceftizoxime, like other cephalosporins, has no activity against Chlamydia trachomatis. Therefore, when cephalosporins are used in the treatment of patients with pelvic inflammatory disease and C. trachomatis is one of the suspected pathogens, appropriate antichlamydial coverage should be added.

### IntraAbdominal Infections
- Escherichia coli
- Staphylococcus epidermidis]
- Streptococcus spp. (excluding enterococci)
- Enterobacter spp.
- Klebsiella spp.
- Bacteroides spp. including B. fragilis;
- Anaerobic cocci, including Peptococcus spp. and Peptostreptococcus spp.

# Septicemia
- Streptococcus spp. including S. pneumoniae (but excluding enterococci)
- Staphylococcus aureus (penicillinase and nonpenicillinaseproducing)
- Escherichia coli
- Bacteroides spp. including B. fragilis
- Klebsiella spp.
- Serratia spp.

### Skin and Skin Structure Infections
- Staphylococcus aureus (penicillinase and nonpenicillinaseproducing)
- Staphylococcus epidermidis
- Escherichia coli
- Klebsiella spp.
- Streptococcus spp. including Streptococcus pyogenes (but excluding enterococci)
- Proteus mirabilis
- Serratia spp.
- Enterobacter spp.
- Bacteroides spp. including B. fragilis
- Anaerobic cocci, including Peptococcus spp. and Peptostreptococcus spp.

### Bone and Joint Infections
- Staphylococcus aureus (penicillinase and nonpenicillinaseproducing)
- Streptococcus spp. (excluding enterococci)
- Proteus mirabilis
- Bacteroides spp.
- Anaerobic cocci, including Peptococcus spp. and Peptostreptococcus spp.

### Meningitis
- Haemophilus influenzae.
Cefizox has also been used successfully in the treatment of a limited number of pediatric and adult cases of meningitis caused by Streptococcus pneumoniae.
Cefizox has been effective in the treatment of seriously ill, compromised patients, including those who were debilitated, immunosuppressed, or neutropenic.
Infections caused by aerobic gramnegative and by mixtures of organisms resistant to other cephalosporins, aminoglycosides, or penicillins have responded to treatment with Cefizox.
Because of the serious nature of some urinary tract infections due to P. aeruginosa and because many strains of Pseudomonas species are only moderately susceptible to Cefizox, higher dosage is recommended. Other therapy should be instituted if the response is not prompt.
Susceptibility studies on specimens obtained prior to therapy should be used to determine the response of causative organisms to Cefizox. Therapy with Cefizox may be initiated pending results of the studies; however, treatment should be adjusted according to study findings. In serious infections, Cefizox has been used concomitantly with aminoglycosides (see PRECAUTIONS). Before using Cefizox concomitantly with other antibiotics, the prescribing information for those agents should be reviewed for contraindications, warnings, precautions, and adverse reactions. Renal function should be carefully monitored.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Cefizox and other antibacterial drugs, Cefizox should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.