From the Guidelines
Avycaz (Ceftazidime-Avibactam) does not cover metallo-β-lactamase (MBL)-producing carbapenem-resistant Enterobacterales (CRE), as it lacks in vitro activity against these isolates. This is based on the most recent and highest quality study available, which states that novel combinations, such as ceftazidime/avibactam and meropenem/vaborbactam, do not show in vitro activity against MBL-producing isolates 1.
Some key points to consider:
- Avycaz is not effective against MBL-producing CRE, which are increasingly reported worldwide 1
- The combination of ceftazidime/avibactam plus aztreonam is recommended for the treatment of infections caused by MBL-producing CRE, due to its in vitro synergy and improved clinical outcomes 1
- Cefiderocol may be an alternative option for infections caused by MBL-producing CRE, although the evidence is still limited and conditional 1
- It is essential to consider the likely pathogens involved in an infection and choose appropriate antibiotic coverage accordingly, taking into account the limitations of Avycaz and the potential need for combination therapy or alternative antibiotics 1
In terms of specific pathogens, Avycaz is not indicated for:
- Gram-positive bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus species
- Anaerobes, such as Clostridium difficile
- Atypical pathogens, such as Mycoplasma, Chlamydia, and Legionella
- Viral or fungal infections
Overall, the choice of antibiotic therapy should be guided by the suspected or confirmed pathogens involved in the infection, as well as the local epidemiology and resistance patterns 1.
From the FDA Drug Label
INDICATIONS AND USAGE FORTAZ is indicated for the treatment of patients with infections caused by susceptible strains of the designated organisms in the following diseases: To reduce the development of drug-resistant bacteria and maintain the effectiveness of FORTAZ and other antibacterial drugs, FORTAZ should be used only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria
The FDA drug label does not answer the question.
From the Research
Infections Not Covered by Avycaz (Ceftazidime-Avibactam)
- Avycaz is a combination antibiotic consisting of ceftazidime and avibactam, and it is primarily used to treat Gram-negative bacterial infections 2.
- The provided studies focus on Gram-positive bacterial infections, such as those caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) 3, 4, 5, 2, 6.
- Avycaz does not cover infections caused by:
- These infections are typically treated with other antibiotics, such as vancomycin, linezolid, daptomycin, and tigecycline 4, 2, 6.