Pronunciation:
sef-tay-zi-deem/a-vi-bak-tam
Trade Name(s)
Ther. Class.
anti-infectives
Pharm. Class.
third generation cephalosporins
beta lactamase inhibitors
Therapeutic Effect(s):
Death of susceptible bacteria with resolution of infection.
Spectrum:
Active against Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Haemophilus influenzae, Enterobacter cloacae, Klebsiella oxytoca, Pseudomonas aeruginosa, Citrobacter freundii, and Serratia marcescens.
Ceftazidime
Absorption: IV administration results in complete bioavailability.
Distribution: Widely distributed to tissues.
Metabolism and Excretion: Minimally metabolized; 80–90% excreted unchanged in urine.
Half-life: 2.8–3.3 hr (↑ in renal impairment).
Avibactam
Absorption: IV administration results in complete bioavailability.
Distribution: Widely distributed to tissues.
Metabolism and Excretion: Minimally metabolized, mainly excreted unchanged in urine.
Half-life: 2.2–2.7 hr.
TIME/ACTION PROFILE (plasma concentrations)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
IV | rapid | end of infusion | 8 hr (↑ in renal impairment) |
Contraindicated in:
Use Cautiously in:
F and E: hypokalemia
GI: CLOSTRIDIOIDES DIFFICILE-ASSOCIATED DIARRHEA (CDAD), diarrhea, nausea, vomiting
Hemat: eosinophilia, thrombocytopenia
Neuro: anxiety, dizziness, headache, SEIZURES (↑ in renal impairment)
Misc: HYPERSENSITIVITY REACTIONS (including anaphylaxis and serious skin reactions)
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
Drug-Drug
Probenecid may ↓ renal excretion of avibactam; concurrent administration is not recommended.
IV (Adults): 2.5 g (2 g ceftazidime/0.5 g avibactam) every 8 hr. Duration of therapy = 5–14 days (complicated intra-abdominal infections); 7–14 days (complicated UTIs or hospital-/ventilator-acquired bacterial pneumonia).
IV (Children ≥2 yr): 62.5 mg/kg (50 mg/kg ceftazidime/12.5 mg/kg avibactam) (max dose = 2.5 g [2 g ceftazidime/0.5 g avibactam]) every 8 hr. Duration of therapy = 5–14 days (complicated intra-abdominal infections); 7–14 days (complicated UTIs or hospital-/ventilator-acquired bacterial pneumonia).
IV (Children 6 mo–<2 yr): 62.5 mg/kg (50 mg/kg ceftazidime/12.5 mg/kg avibactam) every 8 hr. Duration of therapy = 5–14 days (complicated intra-abdominal infections); 7–14 days (complicated UTIs or hospital-/ventilator-acquired bacterial pneumonia).
IV (Children 3 mo–<6 mo): 50 mg/kg (40 mg/kg ceftazidime/10 mg/kg avibactam) every 8 hr. Duration of therapy = 5–14 days (complicated intra-abdominal infections); 7–14 days (complicated UTIs or hospital-/ventilator-acquired bacterial pneumonia).
IV (Children >28 days–<3 mo): 37.5 mg/kg (30 mg/kg ceftazidime/7.5 mg/kg avibactam) every 8 hr. Duration of therapy = 5–14 days (complicated intra-abdominal infections); 7–14 days (complicated UTIs or hospital-/ventilator-acquired bacterial pneumonia).
IV (Children ≤28 days with gestational age ≥31 wk): 25 mg/kg (20 mg/kg ceftazidime/5 mg/kg avibactam) every 8 hr. Duration of therapy = 5–14 days (complicated intra-abdominal infections); 7–14 days (complicated UTIs or hospital-/ventilator-acquired bacterial pneumonia).
Renal Impairment
IV (Adults): CCr 31–50 mL/min: 1.25 g (1 g ceftazidime/0.25 g avibactam) every 8 hr; CCr 16–30 mL/min: 0.94 g (0.75 g ceftazidime/0.19 g avibactam) every 12 hr; CCr 6–15 mL/min: 0.94 g (0.75 g ceftazidime/0.19 g avibactam) every 24 hr; CCr ≤5 mL/min: 0.94 g (0.75 g ceftazidime/0.19 g avibactam) every 48 hr: Hemodialysis: Administer dose after hemodialysis on hemodialysis days.
Renal Impairment
IV (Children ≥2 yr): CCr 31–50 mL/min: 31.25 mg/kg (25 mg/kg ceftazidime/6.25 mg/kg avibactam) (max dose = 1.25 g [1 g ceftazidime/0.25 g avibactam]) every 8 hr; CCr 16–30 mL/min: 23.75 mg/kg (19 mg/kg ceftazidime/4.75 mg/kg avibactam) (max dose = 0.94 g [0.75 g ceftazidime/0.19 g avibactam]) every 12 hr; CCr 6–15 mL/min: 23.75 mg/kg (19 mg/kg ceftazidime/4.75 mg/kg avibactam) (max dose = 0.94 g [0.75 g ceftazidime/0.19 g avibactam]) every 24 hr; CCr ≤5 mL/min: 23.75 mg/kg (19 mg/kg ceftazidime/4.75 mg/kg avibactam) (max dose = 0.94 g [0.75 g ceftazidime/0.19 g avibactam]) every 48 hr; Hemodialysis: Administer dose after hemodialysis or on hemodialysis days.
Powder for injection: ceftazidime 2 g/avibactam 0.5 g/vial
Lab Test Considerations:
May cause seroconversion from a negative to a positive direct Coombs' test. If anemia develops during or after therapy, perform a direct Coombs' test.
Resolution of the signs and symptoms of infection. Length of time for complete resolution depends on the organism and site of infection.
ceftazidime/avibactamis the Anesthesia Central Word of the day!