What is the procedure for administering 1.25g of Zavicefta (Ceftazidime and Avibactam) when only a 2.5g vial is available?

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From the Guidelines

To administer a 1.25g dose of Zavicefta when only a 2.5g vial is available, reconstitute the 2.5g vial according to the manufacturer's instructions, then withdraw and use exactly half of the resulting solution. This approach is based on the principle that the active ingredients, ceftazidime and avibactam, are evenly distributed in the solution, allowing for accurate dosing by volume 1. The recommended treatment options for carbapenem-resistant Enterobacterales (CRE) include Ceftazidime/avibactam 2.5 g IV q8h, as outlined in the guidelines for the treatment of infections due to multidrug-resistant organisms 1. However, in this scenario, we need to administer a lower dose of 1.25g, which can be achieved by reconstituting the 2.5g vial and using half of the solution. The process involves adding 10mL of sterile water for injection to the 2.5g vial, shaking gently to dissolve, and then withdrawing exactly half of the solution (5mL), which will contain the desired dose of ceftazidime 1g and avibactam 0.25g (total 1.25g) 1. It is essential to use aseptic technique throughout this process and administer the medication promptly after preparation to maintain efficacy and sterility. The remaining solution should be discarded, as Zavicefta does not contain preservatives, and stability cannot be guaranteed once reconstituted. By following this procedure, healthcare professionals can ensure accurate dosing and effective treatment for patients requiring a 1.25g dose of Zavicefta when only a 2.5g vial is available. Key considerations include:

  • Using aseptic technique to maintain sterility
  • Administering the medication promptly after preparation
  • Discarding the remaining solution due to the lack of preservatives
  • Ensuring accurate dosing by using exactly half of the reconstituted solution.

From the Research

Administration Procedure

To administer 1.25g of Zavicefta (Ceftazidime and Avibactam) when only a 2.5g vial is available, the following steps can be considered:

  • The approved dosage of Ceftazidime-avibactam is 2g-0.5g administered as a 2-hour infusion every 8 hours 2.
  • However, there is no direct information available in the provided studies on how to administer 1.25g of Zavicefta when only a 2.5g vial is available.
  • It can be inferred that the 2.5g vial contains 2g of Ceftazidime and 0.5g of Avibactam, based on the approved dosage 2.
  • To administer 1.25g of Zavicefta, it would be necessary to reconstitute the 2.5g vial and then withdraw half of the reconstituted solution, assuming the ratio of Ceftazidime to Avibactam remains constant.

Key Considerations

  • The ratio of Ceftazidime to Avibactam in the 2.5g vial is 2g:0.5g or 4:1 2.
  • When reconstituting the 2.5g vial, it is essential to follow the recommended reconstitution procedure to ensure the stability and sterility of the solution.
  • The reconstituted solution should be used immediately, and any unused portion should be discarded 2.

Available Information

  • The provided studies discuss the efficacy, safety, and pharmacokinetics of Ceftazidime-avibactam but do not provide specific guidance on administering 1.25g of Zavicefta when only a 2.5g vial is available 3, 2, 4, 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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