Ceftazidime and avibactam

(Avycaz®)

Avycaz®

Drug updated on 10/31/2024

Dosage FormInjection (intravenous; 2 g ceftazidime [equivalent to 2.635 grams of ceftazidime pentahydrate/sodium carbonate powder] and 0.5 g avibactam [equivalent to 0.551 grams of avibactam sodium])
Drug ClassCephalosporin antibacterials and beta lactamase inhibitors
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of complicated intra-abdominal infections (cIAI), used in combination with metronidazole, in adult and pediatric patients (at least 31 weeks gestational age), caused by designated susceptible Gram-negative microorganisms
  • Indicated for the treatment of complicated urinary tract infections (cUTI), including pyelonephritis, in adult and pediatric patients (at least 31 weeks gestational age), caused by designated susceptible Gram-negative microorganisms
  • Indicated for the treatment of hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP), in adult and pediatric patients (at least 31 weeks gestational age), caused by designated susceptible Gram-negative microorganisms.

Latest News

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Summary
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  • This summary is based on the review of 18 systematic review(s)/meta-analysis(es). [1-18]
  • Mortality and Clinical Cure Rates in Nosocomial Infections: Ceftazidime/avibactam demonstrated lower mortality rates (OR (odds ratio) 2.73, 95% CI (confidence interval) 1.59-4.69) and higher clinical cure rates compared to polymyxin B in patients with multidrug-resistant infections, including carbapenem-resistant Enterobacterales (CRE).
  • Efficacy in Nosocomial Pneumonia: Ceftazidime/avibactam showed a lower clinical failure rate than ceftazidime alone (OR = 1.48, 95% CrI [1.02-2.20]), though no significant difference in 28-day mortality was observed among beta-lactam regimens.
  • Effectiveness in Complicated Intra-Abdominal Infections (cIAI): While ceftazidime/avibactam combined with metronidazole had higher adverse event-related discontinuations compared to meropenem, eravacycline showed improved microbiological response rates over tigecycline in cIAI.
  • CRE and Multidrug-Resistant Infections: Ceftazidime/avibactam demonstrated lower mortality and higher clinical cure rates compared to colistin-based therapies in CRE infections, with synergistic effects noted when combined with agents such as aztreonam and amikacin.
  • Adverse Events and Discontinuations: Ceftazidime/avibactam, when combined with metronidazole, showed higher discontinuation rates due to adverse events compared to meropenem in complicated intra-abdominal infections (cIAI).
  • Nephrotoxicity: Ceftazidime/avibactam demonstrated lower nephrotoxicity rates than colistin-based regimens and polymyxin B, indicating a favorable nephrotoxicity profile compared to these alternatives in treating CRE and multidrug-resistant infections.
  • Resistance Development: Emergence of resistance to ceftazidime/avibactam was observed, particularly in Klebsiella pneumoniae carbapenemase (KPC)-producing strains, suggesting a notable risk in prolonged or specific clinical contexts.
  • Ceftazidime/avibactam demonstrated reduced mortality and higher clinical cure rates in the general population with nosocomial infections, showed favorable efficacy and safety profiles in newborns and pediatric patients with multidrug-resistant infections, and was effective in treating CRE infections with a lower nephrotoxicity risk compared to colistin-based regimens.

Product Monograph / Prescribing Information

Document TitleYearSource
Avycaz (ceftazidime and avibactam) Prescribing Information.2024AbbVie Inc., North Chicago, IL

Systematic Reviews / Meta-Analyses

Document TitleYearSource
A Systematic Review of the Pharmacokinetics and Pharmacodynamics of Novel Beta-Lactams and Beta-Lactam with Beta-Lactamase Inhibitor Combinations for the Treatment of Pneumonia Caused by Carbapenem-Resistant Gram-Negative Bacteria2024International Journal of Antimicrobial Agents
Efficiency of polymyxin B treatment against nosocomial infection: a systematic review and meta-analysis2024Frontiers in Medicine
Friends or foes? Novel antimicrobials tackling MDR/XDR Gram-negative bacteria: a systematic review2024Frontiers in Microbiology
Efficacy and safety of antibiotics targeting Gram-negative bacteria in nosocomial pneumonia: a systematic review and Bayesian network meta-analysis2024Annals of Intensive Care
Effectiveness and safety of cefotaxime combined with avibactam for treating multidrug-resistant E coli infections: A systematic review and meta-analysis2024Medicine
In vitro, in vivo and clinical studies comparing the efficacy of ceftazidime-avibactam monotherapy with ceftazidime-avibactam-containing combination regimens against carbapenem-resistant Enterobacterales and multidrug-resistant Pseudomonas aeruginosa isolates or infections: a scoping review2023Frontiers in Medicine
New Antimicrobials for the Treatment of Neonatal Sepsis Caused by Multi-Drug-Resistant Bacteria: A Systematic Review2023Antibiotics (Basel, Switzerland)
Efficacy, safety, and tolerability of antimicrobial agents for complicated intra-abdominal infection: a systematic review and network meta-analysis2023BMC Infectious Diseases
Clinical efficacy of renal dosing adjustments of ceftazidime-avibactam in patients affected by carbapenem-resistant Gram-negative infections: A systematic review and meta-analysis of observational studies2023British Journal of Clinical Pharmacology
Mortality-Related Risk Factors and Novel Antimicrobial Regimens for Carbapenem-Resistant Enterobacteriaceae Infections: A Systematic Review2022Infection and Drug Resistance
The efficacy and safety of eravacycline compared with current clinically common antibiotics in the treatment of adults with complicated intra-abdominal infections: A Bayesian network meta-analysis2022Frontiers in Medicine
Efficacy and Safety of Ceftazidime-Avibactam for the Treatment of Carbapenem-Resistant Enterobacterales Bloodstream Infection: a Systematic Review and Meta-Analysis2022Microbiology Spectrum
Evaluating the clinical effectiveness of new beta-lactam/beta-lactamase inhibitor combination antibiotics: A systematic literature review and meta-analysis2021Antimicrobial Stewardship & Healthcare Epidemiology
The Revival of Aztreonam in Combination with Avibactam against Metallo-beta-Lactamase-Producing Gram-Negatives: A Systematic Review of In Vitro Studies and Clinical Cases2021Antibiotics (Basel, Switzerland)
Ceftazidime-Avibactam for the Treatment of Serious Gram-Negative Infections with Limited Treatment Options: A Systematic Literature Review2021Infectious Diseases and Therapy
Resistance to ceftazidime/avibactam in infections and colonisations by KPC-producing Enterobacterales: a systematic review of observational clinical studies2021Journal of Global Antimicrobial Resistance
Spatio-Temporal Distribution of Acinetobacter baumannii in Germany-A Comprehensive Systematic Review of Studies on Resistance Development in Humans (2000-2018)2020Microorganisms
Ceftazidime/avibactam versus carbapenems for the treatment of infections caused by Enterobacteriaceae: A meta-analysis of randomised controlled trials2019International Journal of Antimicrobial Agents

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