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| Combination of | |
|---|---|
| Ceftazidime | Cephalosporinantibiotic |
| Avibactam | β-lactamase inhibitor |
| Clinical data | |
| Trade names | Avycaz, Zavicefta, others[1] |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a615018 |
| License data | |
| Pregnancy category |
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| Routes of administration | Intravenous infusion |
| ATC code | |
| Legal status | |
| Legal status | |
| Identifiers | |
| CAS Number | |
| PubChemCID | |
| KEGG | |
 N Y (what is this?) | |
Ceftazidime/avibactam, sold under the brand nameAvycaz (by AbbVie) among others, is afixed-dose combination medication composed ofceftazidime, acephalosporin antibiotic, andavibactam, aβ-lactamase inhibitor.[4] It is used to treat complicatedintra-abdominal infections,urinary tract infections, andpneumonia.[4][5] It is only recommended when other options are not appropriate.[4] It is given by infusion into a vein.[4]
Common side effect include nausea, fever, liver problems, headache, trouble sleeping, and pain at the site of infusion.[4] Severe side effects may includeanaphylaxis,seizures, andClostridioides difficile-associated diarrhea.[4] While use appears to be safe inpregnancy the medication has not been well studied in this group.[6] Doses should be adjusted in those withkidney problems.[7] Ceftazidime works by interfering with the building of thebacterial cell wall while avibactam works by preventing ceftazidime's breakdown.[4]
The combination was approved for medical use in the United States and the European Union in 2015.[4][5] It is on theWorld Health Organization's List of Essential Medicines.[8] Resistances are increasingly been reported with United States,Greece andItaly accounting for 80% of cases.[9]
Ceftazidime/avibactam is used to treat certainmultidrug-resistantgram-negative infections.[10]
Ceftazidime/avibactam is used for the treatment of:
For many bacterial infections, it offers little or no advantage over ceftazidime monotherapy, due to the widespread expression of resistance mechanisms other than β-lactamase production. These includeHaemophilus,Moraxella andNeisseria pathogens, and infections caused byAcinectobacter baumannii.[10]
The antibacterial spectrum of ceftazidime/avibactam includes nearly allEnterobacteriaceae, including ceftazidime-resistant strains. The activity of ceftazidime/avibactam against the important hospital pathogenPseudomonas aeruginosa is variable, due to the potential presence of other resistance mechanisms in addition to β-lactamase production. Synergy was observed for avibactam with ceftazidime inBurkholderia infections.[12]
When used to treat life-threatening infections, ceftazidime/avibactam is more likely than carbapenem antibiotics to cause serious adverse events, including worsening kidney function and gastrointestinal adverse effects.[13]
Bacterial resistance to cephalosporins is often due to bacterial production ofβ-lactamase enzymes that deactivate these antibiotics. Avibactam inhibits some (but not all) bacterial β-lactamases. Also, some bacteria are resistant to cephalosporins by other mechanisms, and therefore avibactam doesn't work. Avibactam is not active againstNew Delhi metallo-β-lactamase 1 (NDM-1).[14] Avibactam inhibitsKlebsiella pneumoniaecarbapenemases (KPCs), andAmpC-type β-lactamases, which are resistant to the other clinically available β-lactamases,tazobactam andclavulanic acid.[15]
It was granted approval for marketing in the United States by the Food and Drug Administration (FDA) in February 2015.[16] It was granted approval for marketing inEurope by theEuropean Medicines Agency in 2016. During its clinical development, ceftazidime/avibactam was designated as a Qualified Infectious Disease Product under theGenerating Antibiotic Incentives Now provision of theFood and Drug Administration Safety and Innovation Act.[17][18] Development of ceftazidime/avibactam wasfast-tracked by the FDA due to the shortage of drugs for treatment of infections due to antibiotic-resistant bacteria.[citation needed]
