From the Guidelines
Ceftazidime-avibactam is not recommended for the treatment of meningitis based on the provided evidence, as there is no specific dosage guidance for this indication in the study 1. However, considering the need for effective treatment of multidrug-resistant infections, including those that could potentially cause meningitis, the dosage used for other severe infections could be considered as a basis for treatment. The recommended dosage for severe infections, such as bloodstream infections, is 2.5 g IV q8h, as per the guidelines 1. It's crucial to note that this dosage is not specifically approved or recommended for meningitis, and its use in this context would be off-label. Given the severity of meningitis and the importance of achieving adequate central nervous system penetration, the dosage of 2.5 grams (2 grams ceftazidime plus 0.5 grams avibactam) administered intravenously every 8 hours could be considered, with close monitoring and adjustments as necessary for patients with renal impairment. Treatment duration and the decision to use combination therapy should be individualized based on the causative organism, clinical response, and patient-specific factors, as suggested by the guidelines for other infections 1. In clinical practice, the decision to use ceftazidime-avibactam for meningitis would require careful consideration of the potential benefits and risks, given the lack of specific guidance for this indication.
From the Research
Ceftazidime-Avibactam Dosage for Meningitis
- The recommended dosage of Ceftazidime-Avibactam for the treatment of meningitis is not explicitly stated in the provided studies.
- However, a study from 1986 2 evaluated the treatment of bacterial meningitis with ceftazidime in 19 pediatric patients, with a dosage of 150 mg/kg/day divided into eight hourly doses for a mean of 15 days.
- Another study from 2024 3 assessed the adequacy of dosing strategies and infusion durations of ceftazidime/avibactam, but did not provide specific recommendations for meningitis.
- A study from 1987 4 mentioned that ceftazidime can be used to treat meningitis due to Pseudomonas aeruginosa, but did not provide a specific dosage.
- A study from 1983 5 measured the penetration of ceftazidime into cerebrospinal fluid of patients with bacterial meningitis, with concentrations ranging from 2 to 30 micrograms/ml.
- A study from 1990 6 treated 10 pediatric patients with Pseudomonas meningitis with ceftazidime, with dosages ranging from 109 to 300 mg/kg/day, but did not provide a specific recommendation for Ceftazidime-Avibactam.
Key Findings
- Ceftazidime has been shown to be effective in treating bacterial meningitis caused by Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis 2, 4.
- Ceftazidime-Avibactam may be useful in treating meningitis caused by Pseudomonas species 6.
- The dosage and infusion duration of Ceftazidime-Avibactam may need to be adjusted based on the severity of the infection and the patient's renal function 3.