Part III: Guidelines for Selected Antimicrobial Use

3.8 Ceftazidime-avibactam

Avibactam is a non-β-lactam β-lactamase inhibitor that binds covalently and reversibly to β-lactamases. [252]
In vitro activity against Enterobacterales, including those producing ESBL, Ambler class C (e.g. AmpC), and some of the class D β-lactamases (e.g. OXA-48). [253,254]
Ceftazidime-avibactam can be used to treat Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria. [255,256] In combination with aztreonam, it can be used to treat New Delhi metallo-β-lactamase (NDM)-producing bacteria. [256,257] However, caution is advised in these cases due to the potential for resistance. [258,259]
Clinical data on CRE are limited to observational, mostly retrospective, non-comparative studies. [254]
Ceftazidime-avibactam can be used to treat complicated intra-abdominal infections (in combination with metronidazole), complicated urinary tract infections, hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia, caused by susceptible Gram-negative microorganisms.
Dosing [135]

Adults with creatinine clearance (CrCl) >50 mL/min

Ceftazidime-avibactam 2.5 g (ceftazidime 2 g and avibactam 0.5 g), every 8 hours, infusion for 2 hours

Dose adjustment is needed in persons with CrCl ≤50 mL/min.

Please consult a clinical microbiologist or infectious disease physician for the use of ceftazidime-avibactam.