Ceftazidime-avibactam: Difference between revisions
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**Inhibitis class A, C, and some class D beta-lactamases, includign OXA-48 |
**Inhibitis class A, C, and some class D beta-lactamases, includign OXA-48 |
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**No activity against class B |
**No activity against class B |
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**Reduces MIC to ceftazidime in most Enterobacterales including [[Pseudomonas]] |
**Reduces MIC to ceftazidime in most [[Enterobacterales]] including [[Pseudomonas]] |
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**Does not induce AmpC expression |
**Does not induce AmpC expression |
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**Slowly-reversible inhibitor that gets |
**Slowly-reversible inhibitor that gets recycled |
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===Spectrum of Activity=== |
===Spectrum of Activity=== |
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*GNBs |
*GNBs |
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**Active against carbapenem |
**Active against carbapenem-resistant [[Enterobaceriaceaea]], including KPCs and AmpC beta-lactamases |
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**Restores activity with |
**Restores activity with [[ceftazidime]] in [[Pseudomonas]] and other GNBs |
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**Poor activity against [[Acinetobacter]] and [[Stenotrophomonas]] |
**Poor activity against [[Acinetobacter]] and [[Stenotrophomonas]] |
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*Primarily renally cleared |
*Primarily renally cleared |
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==Dosing== |
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* |
*Ceftazidime-avibactam 2.5 g (2 g / 0.5 g) IV q8h, infused over 3 hours |
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**Consider adjunctive [[aztreonam]] 2 g IV q8h infused concurrently over 3 hours for metallo-β-lactamase-producing carbapenem-resistant [[Enterobacterales]] or [[Stenotrophomonas maltophilia]] |
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===Pediatric Dosing=== |
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*3 months to <6 months: ceftazidime 40 mg/kg plus avibactam 10 mg/kg IV q8h, infused over 2 hours |
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*6 months to <18 years: ceftazidime 50 mg/kg plus avibactam 12.5 mg/kg IV q8h, infused over 2 hours |
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Latest revision as of 19:05, 24 November 2021
Background
- Brand name Avycaz
Mechanism of Action
- Ceftazidime is a third-generation cephalosporin
- Avibactam
- Inhibitis class A, C, and some class D beta-lactamases, includign OXA-48
- No activity against class B
- Reduces MIC to ceftazidime in most Enterobacterales including Pseudomonas
- Does not induce AmpC expression
- Slowly-reversible inhibitor that gets recycled
Spectrum of Activity
- GNBs
- Active against carbapenem-resistant Enterobaceriaceaea, including KPCs and AmpC beta-lactamases
- Restores activity with ceftazidime in Pseudomonas and other GNBs
- Poor activity against Acinetobacter and Stenotrophomonas
Pharmacokinetics and Pharmacodynamics
- Short half-life 2.7 hours
- Low protein binding
- Primarily renally cleared
Dosing
- Ceftazidime-avibactam 2.5 g (2 g / 0.5 g) IV q8h, infused over 3 hours
- Consider adjunctive aztreonam 2 g IV q8h infused concurrently over 3 hours for metallo-β-lactamase-producing carbapenem-resistant Enterobacterales or Stenotrophomonas maltophilia
Pediatric Dosing
- 3 months to <6 months: ceftazidime 40 mg/kg plus avibactam 10 mg/kg IV q8h, infused over 2 hours
- 6 months to <18 years: ceftazidime 50 mg/kg plus avibactam 12.5 mg/kg IV q8h, infused over 2 hours
