Antimicrobials
Ceftazidime/Avibactam

Ceftazidime/Avibactam

Restricted

Medium
N/A

Spectrum of Activity

Dosing

General Information

Administration

  • Intermittent IV infusion over 2 hours

Preparation

  • Reconstitute vial with 10mL of NS, D5W, SWFI
  • Resulting concentration is ceftazidime 167mg/mL and avibactam 42mg/mL
  • Mix gently until completely dissolved
  • Further dilute to achieve final concentration of ceftazidime 8-40mg/mL and avibactam 2-10mg/mL
  • Solution should range in color from clear to light yellow

Compatibility

  • D5W, LR, NS
  • Complicated intra-abdominal infections
  • Pneumonia (HAP and VAP)
  • Complicated UTIs (inclusing pyelonephritis)

Tier Four

  • Last line option, uncommonly used based upon susceptibility data, may rarely be used for special scenarios
  • Strategies used: ASP Prior Authorization for Non-Formulary, Prescriber-based restriction, outpatient use

Appropriate uses: ID specialist to order

  • Allergy/intolerance to all alternatives
  • Documented ESBL, KPC, AmpC, CMY or OXA-48 species
  • If Pseudomonas aeruginosa: documented resistance to meropenem, cefepime, piperacillin-tazobactam and ceftolozane-tazobactam with documented beta-lactamase inhibitor

Renal function at baseline and at least daily with changing renal function

  • Positive coombs test
  • Injection site phlebitis
  • Skin rash
  • N/V/D
  • constipation
  • upper abdominal pain
  • Probenecid: contraindicated with avibactam concurrent use
  • Chloramphenicol: diminishes therapeutic effect of Ceftazidime
  • Aminoglycosides: enhance nephrotoxic effects of AGs
  • Vitamin K Antagonists: enhance anticoagulation effect of warfarin

Average half-life: 3.27 hours after single dose and 2.76 hours after multiple doses for ceftazidime. 2.22 hours after single dose and 2.71 hours after multiple doses for avibactam

Urine penetration: Therapeutic, 80-90% of unchanged drug excreted into urine