From the Guidelines
Ceftazidime-avibactam is typically dosed at 2.5 grams (2 grams ceftazidime plus 0.5 grams avibactam) administered intravenously every 8 hours for patients with normal renal function. The recommended dosage is based on the most recent and highest quality study, which provides guidelines for the treatment of infections due to multidrug-resistant organisms 1.
Key Considerations
- The infusion should be given over 2 hours.
- Dosage adjustments are required for patients with impaired kidney function:
- For creatinine clearance 31-50 mL/min, reduce to 1.25 grams every 8 hours.
- For 16-30 mL/min, give 0.94 grams every 12 hours.
- For 6-15 mL/min, administer 0.94 grams every 24 hours.
- For patients on hemodialysis, 0.94 grams should be given after each dialysis session.
Treatment Duration and Indications
- Treatment duration typically ranges from 5 to 14 days depending on the infection site and severity.
- This antibiotic combination is used for:
- Complicated intra-abdominal infections
- Complicated urinary tract infections
- Hospital-acquired pneumonia
- Infections caused by multidrug-resistant gram-negative organisms The avibactam component inhibits beta-lactamase enzymes that would normally break down ceftazidime, making this combination effective against many resistant bacteria including certain carbapenemase-producing organisms 1.
From the FDA Drug Label
The mean pharmacokinetic parameters for ceftazidime and avibactam in healthy adult male subjects with normal renal function after single and multiple 2-hour intravenous infusions of AVYCAZ 2.5 grams (ceftazidime 2 grams and avibactam 0.5 grams) administered every 8 hours are summarized in Table 14. AVYCAZ 2.5 grams (ceftazidime and avibactam) for injection is supplied as a white to yellow sterile powder for constitution in a single-dose, sterile, clear glass vial containing ceftazidime 2 grams (equivalent to 2.635 grams of ceftazidime pentahydrate/sodium carbonate powder) and avibactam 0.5 grams (equivalent to 0.551 grams of avibactam sodium).
The dosage of Ceftazidime and Avibactam is:
- Ceftazidime: 2 grams
- Avibactam: 0.5 grams Administered as a 2-hour intravenous infusion of AVYCAZ 2.5 grams every 8 hours 2, 2.
From the Research
Dosage of Ceftazidime and Avibactam
The dosage of Ceftazidime and Avibactam is as follows:
- Ceftazidime: 2000 mg
- Avibactam: 500 mg This combination is administered every 8 hours by 2-hour intravenous infusion for patients with creatinine clearance (CLCR) >50 ml/min 3. For patients with CLCR ≤50 ml/min, modified dosage regimens are recommended 3.
Dosing Recommendations in Specific Patient Populations
- Critically ill patients with normal renal function: 2.5 g Ceftazidime-Avibactam infused over 2 hours every 8 hours may be appropriate 4.
- Patients with severe infections and normal renal function: extended infusion durations of 3 hours and 4 hours may be necessary to achieve target pharmacodynamic indices 5.
- Patients with nosocomial pneumonia: 2000/500 mg by 2-hour intravenous infusion every 8 hours, adjusted for renal function, has been shown to be effective 6.
Pharmacokinetic Parameters
The pharmacokinetic parameters of Ceftazidime and Avibactam are:
- Ceftazidime:
- Maximum serum concentration (Cmax): 152.39 μg/ml
- Half-life: 5.17 hours
- Volume of distribution at steady state (Vdss): 11.51 L
- Clearance: 1.54 L/hour
- Area under the concentration-time curve (AUC): 1295.38 hour•μg/ml 4
- Avibactam:
- Cmax: 35.83 μg/ml
- Half-life: 5.92 hours
- Vdss: 12.44 L
- Clearance: 1.45 L/hour
- AUC: 343.44 hour•μg/ml 4