Ceftazidime-avibactam: Difference between revisions

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(Created page with "== Background == * Brand name Avycaz === Mechanism of Action === * Ceftazidime is a third-generation cephalosporin * Avibactam ** Inhibitis class A, C, and some cla...")
 
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== Background ==
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==Background==
   
* Brand name Avycaz
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*Brand name Avycaz
   
=== Mechanism of Action ===
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===Mechanism of Action===
   
* [[Ceftazidime]] is a third-generation cephalosporin
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*[[Ceftazidime]] is a third-generation cephalosporin
* [[Avibactam]]
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*[[Avibactam]]
** Inhibitis class A, C, and some class D beta-lactamases, includign OXA-48
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**Inhibitis class A, C, and some class D beta-lactamases, includign OXA-48
** No activity against class B
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**No activity against class B
** Reduces MIC to ceftazidime in most Enterobacterales including [[Pseudomonas]]
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**Reduces MIC to ceftazidime in most [[Enterobacterales]] including [[Pseudomonas]]
** Does not induce AmpC expression
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**Does not induce AmpC expression
** Slowly-reversible inhibitor that gets recycld
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**Slowly-reversible inhibitor that gets recycled
   
=== Spectrum of Activity ===
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===Spectrum of Activity===
   
* GNBs
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*GNBs
** Active against carbapenem resistant [[Enterobaceriaceaea]], including KPCs and AmpC lactamases-
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**Active against carbapenem-resistant [[Enterobaceriaceaea]], including KPCs and AmpC beta-lactamases
** Restores activity with cefatzidime in [[Pseudomonas]] and other GNBs
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**Restores activity with [[ceftazidime]] in [[Pseudomonas]] and other GNBs
** Poor activity against [[Acinetobacter]] and [[Stenotrophomonas]]
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**Poor activity against [[Acinetobacter]] and [[Stenotrophomonas]]
   
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===Pharmacokinetics and Pharmacodynamics===
=== PK/PD ===
 
   
* Short half-life 2.7 hours
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*Short half-life 2.7 hours
* Low protein binding
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*Low protein binding
* Primarily renally cleared
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*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

Latest revision as of 15:05, 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

Pharmacokinetics and Pharmacodynamics

  • Short half-life 2.7 hours
  • Low protein binding
  • Primarily renally cleared

Dosing

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