Ceftazidime-Avibactam (Avycaz)

Indications

  • Acinetobacter (see Acinetobacter, [[Acinetobacter]])
  • Family Enterobacteriaceae (colloquially termed “enteric bacteria”): including those that produce extended-spectrum β-lactamases (ESBL), Klebsiella pneumoniae carbapenemases (KPC’s), and/or AmpC ß-lactamases
  • Family Pseudomonadaceae

Specific Infectious Indications

  • Complicated Urinary Tract Infection: non-inferior to standard carbapenem therapy
  • Hospitalized Patients with Complicated Intra-Abdominal Infection: RECLAIM-1 Trial (Phase III) + RECLAIM-2 Trial (Phase III): Ceftazidime + Avibactam used in combination with Metronidazole demonstrated non-inferiority to Meropenem -> endpoint: clinical cure rate at 28-35 days after randomization

Pharmacology

  • Ceftazidime (see Ceftazidime, [[Ceftazidime]])
  • Azibactam: synthetic β-lactamase inhibitor
    • Chemical structure of avibactam resembles portions of the cephem bicyclic ring system -> avibactam binds covalently to β-lactamases
    • Avibactam significantly improves the activity of ceftazidime versus most species of Enterobacteriaceae (depending on the presence or absence of β-lactamase enzyme)
    • Avibactam significantly improves the activity of ceftazidime versus Pseudomonas Aeruginosa
    • Limited data suggest that avibactam does not improve the activity of ceftazidime versus Acinetobacter or most anaerobic bacteria (with the exception of Bacteroides Fragilis, Clostridium Perfringens, Prevotella, and Porphyromonas)
    • Little is known about the potential for avibactam to select for resistance

Administration

  • IV: xxx

Adverse Effects

Other Adverse Effects

  • xxx
  • xxx

References

  • Ceftazidime-avibactam: a novel cephalosporin/β-lactamase inhibitor combination. Drugs. 2013 Feb;73(2):159-77. doi: 10.1007/s40265-013-0013-7 [MEDLINE]