From the Guidelines
The recommended dose of ceftazidime-avibactam for adults with normal renal function is 2.5 g IV q8h, as indicated in the latest guidelines for treating infections due to multidrug-resistant organisms 1. This dose is specifically recommended for infections due to difficult-to-treat Pseudomonas aeruginosa (DTR-PA) and is part of a broader strategy to combat antimicrobial resistance. Key points to consider when administering ceftazidime-avibactam include:
- The dose consists of 2 grams of ceftazidime and 0.5 grams of avibactam, administered intravenously every 8 hours.
- The treatment duration can range from 5 to 14 days, depending on the type of infection being treated, such as complicated urinary tract infections, intra-abdominal infections, hospital-acquired pneumonia, or ventilator-associated pneumonia.
- It is crucial to follow the manufacturer's instructions for reconstitution and dilution before infusion.
- Dosage adjustments are necessary for patients with renal impairment, defined as a creatinine clearance of ≤50 mL/min. The combination of ceftazidime and avibactam is effective against a wide range of gram-negative bacteria, including those producing extended-spectrum beta-lactamases (ESBLs) and carbapenemases, making it a valuable option in the treatment of multidrug-resistant infections 1.
From the FDA Drug Label
The usual adult dosage is 1 gram administered intravenously or intramuscularly every 8 to 12 hours.
Table 3. Recommended Dosage Schedule Dose Frequency Adults Usual recommended dosage 1 gram intravenous or intramuscular every 8 to 12 hours
The recommended dose of ceftazidime-avibactam for adults with normal renal function is 1 gram administered intravenously or intramuscularly every 8 to 12 hours 2.
From the Research
Ceftazidime-Avibactam Dosing for Adults with Normal Renal Function
- The recommended dose of ceftazidime-avibactam for adults with normal renal function is 2 grams of ceftazidime and 0.5 grams of avibactam administered every 8 hours as a 2-hour intravenous infusion 3.
- This dosing regimen has been shown to achieve sufficient joint probability of target attainment for ceftazidime minimum inhibitory concentration (MIC) of 8 mg/L at a fixed 4 mg/L avibactam concentration (MIC ≤ 8/4 mg/L) 3.
- The clinical dosing regimen of 2/0.5 g ceftazidime/avibactam administered every 8 hours as a 2-hour intravenous infusion in patients with normal renal function has demonstrated statistical non-inferiority to carbapenem in phase III studies on the treatment of complicated intra-abdominal infection, complicated urinary tract infection, and nosocomial pneumonia, including ceftazidime non-susceptible Gram-negative pathogens 3.
Rationale for Dosing Regimen
- The dosing regimen is based on population pharmacokinetic models that incorporate body weight, disease state, ethnicity, and renal function (creatinine clearance) as covariates of clearance and volume of distribution 3.
- The models were validated using a mathematical model based on kill-curve kinetics to validate the dose selection in humans 3.
- The dosing regimen has been evaluated in several clinical trials, including phase III studies, and has been shown to be effective and safe in the treatment of adults with complicated intra-abdominal infection, complicated urinary tract infection, and hospital-acquired pneumonia, including ventilator-associated pneumonia 4.