[ceftazidime-avibactam photo]
KEY POINTS
- Ceftazidime-avibactam (Avycaz) is the combination of (1) beta-lactam and third generation cephalosporin ceftazidime PLUS (2) beta-lactamase inhibitor avibactam
- Ceftazidime interferes with cell wall synthesis through binding to penicillin-binding-proteins
- Avibactam inactivates some beta-lactamses, which protects ceftazidime from degradation and expands the spectrum of ceftazidime
- First FDA-approved in February 2015 and indications now include:
- Complicated intra-abdominal infections, used with metronidazole
- Complicated urinary tract infection, including pyelonephritis
- Hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia
- Has activity versus a variety of multi-drug resistant Gram negative organisms
- Active versus Pseudomonas aeruginosa
- Can be active against carbapenem-resistant organisms
- Sometimes added to other drugs so that the avibactam can be active. For example as aztreonam-ceftazidime-avibactam for treating NDM-producing Gram negative bacteria
- Does not cover Gram positive organisms methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococci (VRE)
- Common dose is 2.5gm IV three times per day
- Adjust doses for kidney function
- No hepatic dose adjustment listed in package insert
- Beware hypersensitivity reaction, anxiety, constipation, dizziness, diarrhea, CNS effects
- A high cost antibiotic that is only available as a branded product
RESOURCES
- Ceftazidime-avibactam Package Insert
- IDSA Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections: Version 2.0
- Ceftazidime/Avibactam and Ceftolozane/Tazobactam: Second-generation β-Lactam/β-Lactamase Inhibitor Combinations (Clin Infect Dis 2016)
- Gram Negative Resistance Mechanisms: A Leading Pharmacist’s Clinical Perspectives On AmpC, ESBL and KPC (2017)
- Insights On Multidrug-Resistant Pseudomonas (2017)
- Focus On Acinetobacter: An Antibiotic Nightmare (2017)
- Top 5 Unanswered Questions: The Management Of Invasive Infections Due To Multidrug Resistant Gram-Negative Bacteria (2016)
Photo source: www.avycaz.com
