Antimicrobials
Ceftazidime + avibactam

Ceftazidime + avibactam

Spectrum of Activity

Dosing

General Information

  • “Last resort”
  • Highly selected patients (life-threatening infections due to multidrug-resistant bacteria)
  • Their use should be closely monitored and they should be prioritized as targets of stewardship programs to ensure their continued effectiveness
  • Powder for intravenous infusion: 2 g + 500 mg in vial

Targeted Treatment:

  • Severe infections caused by laboratory-confirmed carbapenem-resistant Enterobacterales or Pseudomonas aeruginosa (not Acinetobacter baumannii) susceptible to ceftazidime+avibactam (CAZ-AVI)

Empiric Use:

  • Only in very select cases of seriously ill patients (e.g. patients with sepsis/septic shock):
    • who have not responded to carbapenems if other causes of treatment failure have been excluded first and there is strong suspicion that the infection is caused by a carbapenem-resistant pathogen
    • who have previously been treated for infections caused by carbapenem-resistant pathogens susceptible to CAZ-AVI
    • who are known to be colonized with carbapenem-resistant pathogens susceptible to CAZ-AVI

Important Considerations:

  • When used to treat complicated intra-abdominal infections CAZ-AVI should be given with metronidazole due to its unpredictable activity against anaerobes
  • Since it is not active against metallo-β-lactamases (MBL), it is important to know the local epidemiology of the most prevalent genotypes for aerobic Gram-negative bacteria
  • Side effects are similar to those previously reported for ceftazidime alone
  • The most frequent are diarrhoea, nausea and vomiting
  • Combination of a third-generation cephalosporin (ceftazidime) and a novel non-β-lactam β-lactamase inhibitor (avibactam)

Mechanism of Action:

  • Ceftazidime inhibits bacterial enzymes responsible for cell-wall synthesis
  • Avibactam inactivates certain serine β-lactamases, protecting ceftazidime from degradation

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