Ceftizoxime
| Evidence Level: L5 | Predicted Indications: 5 |
Table of Contents
- Ceftizoxime
Ceftizoxime: From Bacterial Infections to Ureaplasma Urethritis
One-Sentence Summary
Ceftizoxime is a third-generation cephalosporin antibiotic. The TxGNN model predicts it may be effective for Ureaplasma urethritis, but no clinical trials and no publications support this prediction, and the biology argues against it (Ureaplasma has no cell wall).
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Urinary tract infection, gonorrhea, pneumonia and other bacterial infections (relations recorded in the knowledge graph; the licence records compiled for this report contain no indication text) |
| Predicted New Indication | Ureaplasma urethritis |
| TxGNN Prediction Score | 0.9991 |
| Evidence Level | L5 |
| India Market Status | Listed in a compiled Indian medicine price dataset (18 of 18) – CDSCO approval status is not included in this data |
| Number of Listed Products | 18 (valid: 18) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available in the data compiled for this report. Ceftizoxime belongs to the third-generation cephalosporins, which kill bacteria by binding penicillin-binding proteins and blocking cell wall synthesis.
This is the central problem for the predicted indication. Ureaplasma species have no cell wall, so beta-lactam antibiotics such as ceftizoxime are expected to be intrinsically ineffective. The very high TxGNN score is most likely driven by network proximity to other urogenital infections (for example gonorrhea) rather than by real biological support.
The prediction is therefore not considered mechanistically reasonable. It should be treated as a model artefact unless direct evidence emerges.
Other predicted indications (for context)
| Rank | Predicted Indication | Score | Evidence Level | Comment |
|---|---|---|---|---|
| 2 | Xanthogranulomatous pyelonephritis | 0.9988 | L5 | Plausible activity against Proteus and E. coli, but definitive treatment is usually nephrectomy; no supporting studies |
| 3 | Uterine inflammatory disease | 0.9988 | L5* | Mechanistically coherent (gonococcus and anaerobe coverage), but no cited study shows ceftizoxime efficacy in this disease |
| 4 | Epiglottitis | 0.9949 | L5 | Spectrum similar to standard third-generation cephalosporins; no studies |
| 5 | Urogenital tuberculosis | 0.9948 | L5 | Not biologically supported (mycobacterial beta-lactamase); no studies |
*The pack lists L4 for this indication, but the retrieved studies do not demonstrate ceftizoxime efficacy in uterine inflammatory disease itself (one is a preclinical hydrogel study, the other a 1988 pelvic inflammatory disease cohort), so it is reported conservatively here.
Clinical Trial Evidence
Currently no related clinical trials registered for Ureaplasma urethritis.
Literature Evidence
Currently no related literature available for Ureaplasma urethritis.
India Market Information
There are 18 valid single-ingredient licences. None of the licence records include approved indication text. Five main licences are listed below.
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 230404 | Unizox 1gm Injection (United Biotech Pvt Ltd) | Vial of 20 ml injection | Not stated in the records |
| 41380 | Cefizox 500mg Injection (Glaxo SmithKline Pharmaceuticals Ltd) | Vial of 1 injection | Not stated in the records |
| 78749 | Epocelin 1gm Injection (Shreya Life Sciences Pvt Ltd) | Vial of 1 injection | Not stated in the records |
| 78748 | Eldcef 1gm Injection (Elder Pharmaceuticals Ltd) | Vial of 10 ml injection | Not stated in the records |
| 224494 | Trizox 1mg Injection (Osper Formulations Pvt Ltd) | Powder for injection | Not stated in the records |
All products are injectable.
Safety Considerations
- Relations recorded in the knowledge graph (not label text): the knowledge graph links ceftizoxime with the following conditions as contraindications: kidney disease, pyoureter, blood coagulation disease, Clostridium difficile colitis, perinatal necrotizing enterocolitis and congenital prothrombin deficiency.
- Drug Interactions: 12 interactions, all rated Moderate:
- Aminoglycosides: kanamycin, neomycin, streptomycin, amikacin (including liposomal), gentamicin
- Warfarin
- Chloramphenicol
- Picosulfuric acid
- Ethinylestradiol
- Mycophenolic acid
- Pemetrexed
Please refer to the package insert for warnings and label contraindications.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction has no trials or literature behind it, and Ureaplasma lacks a cell wall, so a cell-wall-targeting beta-lactam is not expected to work. The high TxGNN score is not backed by biology.
To proceed, the following is needed:
- Evidence that ceftizoxime has in vitro or clinical activity against Ureaplasma (currently contrary to expectation)
- Package insert warnings and contraindications from Indian licence holders
- Mechanism of action data from DrugBank
- If a urogenital or gynaecological use is of interest, consider uterine inflammatory disease (pelvic inflammatory disease) as a better-grounded research question, which would need prospective comparative data
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.