Avibactam / Ceftazidime Dosage

Medically reviewed on August 22, 2017.

Usual Adult Dose for Intraabdominal Infection

2.5 g IV every 8 hours
Duration of therapy: 5 to 14 days

Comments:
-Metronidazole should be used concomitantly.

Use: In combination with metronidazole, for the treatment of complicated intraabdominal infections due to the following susceptible gram-negative microorganisms: Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterobacter cloacae, K oxytoca, Citrobacter freundii complex, Pseudomonas aeruginosa

Usual Adult Dose for Pyelonephritis

2.5 g IV every 8 hours
Duration of therapy: 7 to 14 days

Uses:
-For the treatment of complicated urinary tract infections (including pyelonephritis) due to the following susceptible gram-negative microorganisms: E coli, K pneumoniae, E cloacae, C freundii complex, P mirabilis, P aeruginosa
-For the treatment of hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia due to K pneumoniae, E cloacae, E coli, Serratia marcescens, P mirabilis, P aeruginosa, Haemophilus influenzae

Usual Adult Dose for Urinary Tract Infection

2.5 g IV every 8 hours
Duration of therapy: 7 to 14 days

Uses:
-For the treatment of complicated urinary tract infections (including pyelonephritis) due to the following susceptible gram-negative microorganisms: E coli, K pneumoniae, E cloacae, C freundii complex, P mirabilis, P aeruginosa
-For the treatment of hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia due to K pneumoniae, E cloacae, E coli, Serratia marcescens, P mirabilis, P aeruginosa, Haemophilus influenzae

Usual Adult Dose for Nosocomial Pneumonia

2.5 g IV every 8 hours
Duration of therapy: 7 to 14 days

Uses:
-For the treatment of complicated urinary tract infections (including pyelonephritis) due to the following susceptible gram-negative microorganisms: E coli, K pneumoniae, E cloacae, C freundii complex, P mirabilis, P aeruginosa
-For the treatment of hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia due to K pneumoniae, E cloacae, E coli, Serratia marcescens, P mirabilis, P aeruginosa, Haemophilus influenzae

Renal Dose Adjustments

Estimated CrCl 31 to 50 mL/min: 1.25 g IV every 8 hours
Estimated CrCl 16 to 30 mL/min: 0.94 g IV every 12 hours
Estimated CrCl 6 to 15 mL/min: 0.94 g IV every 24 hours
Estimated CrCl up to 5 mL/min: 0.94 g IV every 48 hours

Comments:
-CrCl estimated using the Cockcroft-Gault formula.
-CrCl should be monitored at least daily in patients with changing renal function and dose should be adjusted accordingly.

Liver Dose Adjustments

No adjustment recommended.

Precautions

CONTRAINDICATIONS:
Known serious hypersensitivity to either active component, avibactam-containing products, or other cephalosporins

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Estimated CrCl 6 to 15 mL/min: 0.94 g IV every 24 hours
Estimated CrCl up to 5 mL/min: 0.94 g IV every 48 hours

Comments:
-CrCl estimated using the Cockcroft-Gault formula.
-Both components are hemodialyzable; this drug should be administered after hemodialysis on hemodialysis days.
-CrCl should be monitored at least daily in patients with changing renal function and dose should be adjusted accordingly.

Other Comments

2.5 g avibactam-ceftazidime contains 2 g ceftazidime and 0.5 g avibactam
1.25 g avibactam-ceftazidime contains 1 g ceftazidime and 0.25 g avibactam
0.94 g avibactam-ceftazidime contains 0.75 g ceftazidime and 0.19 g avibactam

Administration advice:
-Administer all doses by IV infusion over 2 hours.

Storage requirements:
-Unconstituted vials: Store at 25C (77F); excursions permitted to 15C to 30C (59F to 86F); protect from light.
-After constitution with appropriate diluent: May hold the constituted solution no more than 30 minutes before transfer and dilution in appropriate infusion bag
-After dilution of constituted solutions with appropriate diluents: Solutions in the infusion bags are stable for 12 hours when stored at room temperature; solutions in the infusion bags may also be refrigerated at 2C to 8C (36F to 46F) for up to 24 hours, then should be used within 12 hours of subsequent storage at room temperature

Reconstitution/preparation techniques:
-The dry powder must be constituted and then diluted prior to IV infusion.
-The manufacturer product information should be consulted.

IV compatibility:
-Compatible diluent for constitution only: Sterile water for injection, USP
-Compatible diluents for constitution and dilution: 0.9% sodium chloride injection, USP; 5% dextrose injection, USP; all combinations of dextrose injection and sodium chloride injection, USP, containing up to 2.5% dextrose, USP, and 0.45% sodium chloride, USP; lactated ringer's injection, USP
-At the range of diluted concentrations of ceftazidime 0.008 g/mL and avibactam 0.002 g/mL to ceftazidime 0.04 g/mL and avibactam 0.01 g/mL, this drug is compatible with more commonly used IV infusion fluids in infusions bags (including Baxter[R] Mini-Bag Plus[TM]) such as the above compatible diluents for constitution and dilution and Baxter(R) Mini-Bag Plus(TM) containing 0.9% sodium chloride injection or 5% dextrose injection
-Any drug not listed below should not be coadministered with this drug through the same IV line (or cannula):
---Compatible drugs for use with 0.9% sodium chloride, 5% dextrose, or lactated ringer's injection as diluents: Daptomycin; dexmedetomidine hydrochloride (HCl); dopamine HCl; furosemide; gentamicin sulfate; imipenem-cilastatin; magnesium sulfate; norepinephrine bitartrate; phenylephrine HCl; vasopressin; vecuronium bromide
---Compatible drugs for use with 0.9% sodium chloride or 5% dextrose injection as diluents: Ertapenem sodium; potassium phosphate; sodium glycerophosphate
---Compatible drugs for use with 5% dextrose or lactated ringer's injection as diluents: Heparin sodium; linezolid; tobramycin sulfate
---Compatible drugs for use with 1 compatible diluent only: Meropenem (0.9% sodium chloride injection diluent only); sodium bicarbonate (5% dextrose injection diluent only); tedizolid phosphate (5% dextrose injection diluent only); potassium chloride (lactated ringer's injection diluent only)

General:
-The dose is expressed as the total of ceftazidime content plus avibactam content.
-To reduce the development of drug-resistant organisms and maintain effective therapy, this drug should be used only to treat infections proven or strongly suspected to be caused by susceptible bacteria.
-Culture and susceptibility information should be considered when selecting/modifying antibacterial therapy or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy.

Monitoring:
-Renal: CrCl in patients with changing renal function (at least daily, especially early in therapy); renal function in elderly patients

Patient advice:
-Avoid missing doses and complete the entire course of therapy.
-Consult healthcare provider at once if any neurological signs/symptoms (including encephalopathy [disturbance of consciousness including confusion, hallucinations, stupor, coma], myoclonus, seizures) occur.
-Consult healthcare provider if severe watery or bloody diarrhea develops.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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