What is the recommended dose of Zavicefta (ceftazidime and avibactam) for a 15-year-old patient weighing 42 kilograms?

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Zavicefta Dosing for a 15-Year-Old Weighing 42 kg

For a 15-year-old patient weighing 42 kg, the recommended dose of Zavicefta (ceftazidime-avibactam) is 2.5 grams (ceftazidime 2 grams and avibactam 0.5 grams) administered intravenously every 8 hours over 2 hours, assuming normal renal function. 1

Dosing Rationale

  • Pediatric patients weighing 40 kg or more should receive the standard adult dose of Zavicefta 2.5 grams (ceftazidime 2 grams and avibactam 0.5 grams) every 8 hours by 2-hour IV infusion 1

  • At 42 kg body weight, this 15-year-old patient exceeds the 40 kg threshold where adult dosing becomes appropriate, eliminating the need for weight-based pediatric calculations 1

  • For pediatric patients aged 2 years to less than 18 years with normal renal function (eGFR >50 mL/min/1.73 m²), the maximum dose is capped at 2.5 grams (ceftazidime 2 grams and avibactam 0.5 grams) every 8 hours 1

Administration Details

  • Infusion time must be 2 hours for all Zavicefta doses to ensure appropriate pharmacokinetic exposure 1

  • The dosing interval of every 8 hours should be maintained consistently throughout the treatment course 1

  • For complicated intra-abdominal infections, metronidazole should be administered concurrently at 10 mg/kg IV every 8 hours (maximum 500 mg/dose) 1

Treatment Duration by Indication

  • Complicated intra-abdominal infections: 5 to 14 days 1
  • Complicated urinary tract infections including pyelonephritis: 7 to 14 days 1
  • Hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia: 7 to 14 days 1

Renal Function Considerations

  • This dosing assumes normal renal function (eGFR >50 mL/min/1.73 m²) 1

  • If this patient has renal impairment with eGFR ≤50 mL/min/1.73 m², dose adjustments are required using the Schwartz bedside formula to calculate eGFR 1

  • For eGFR 31-50 mL/min/1.73 m², the dose would be reduced to 1.25 grams (ceftazidime 1 gram and avibactam 0.25 grams) every 8 hours 1

Important Clinical Caveats

  • Both ceftazidime and avibactam are primarily renally cleared, making renal function assessment critical before initiating therapy 2, 3

  • The 4:1 fixed-dose ratio of ceftazidime to avibactam is maintained across all dosing regimens due to their complementary pharmacokinetic profiles with similar half-lives of approximately 2 hours 3

  • This dosing regimen achieves the pharmacodynamic targets of 50% fT>MIC for ceftazidime and 50% fT>1 mg/L for avibactam, which have been validated in phase III trials 3, 4

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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