Avibactam / Ceftazidime Dosage

Usual Adult Dose for Intraabdominal Infection

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

Comments:
-The dose is expressed as the total of ceftazidime content plus avibactam content (in a constant 4:1 ratio).
-Metronidazole should be used concomitantly.

Use: In combination with metronidazole, for the treatment of complicated intraabdominal infections due to the following susceptible microorganisms: Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Providencia stuartii, Enterobacter cloacae, K oxytoca, Pseudomonas aeruginosa

Usual Adult Dose for Pyelonephritis

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

Comments:
-The dose is expressed as the total of ceftazidime content plus avibactam content (in a constant 4:1 ratio).

Uses: For the treatment of complicated urinary tract infections (including pyelonephritis) due to the following susceptible microorganisms: E coli, K pneumoniae, Citrobacter koseri, E aerogenes, E cloacae, C freundii, Proteus species, P aeruginosa

Usual Adult Dose for Urinary Tract Infection

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

Comments:
-The dose is expressed as the total of ceftazidime content plus avibactam content (in a constant 4:1 ratio).

Uses: For the treatment of complicated urinary tract infections (including pyelonephritis) due to the following susceptible microorganisms: E coli, K pneumoniae, Citrobacter koseri, E aerogenes, E cloacae, C freundii, Proteus species, P aeruginosa

Renal Dose Adjustments

Estimated CrCl greater than 50 mL/min: 2.5 g IV every 8 hours
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 5 mL/min or less: 0.94 g IV every 48 hours

Comments: CrCl should be monitored at least daily in patients with changing renal function and the dose should be adjusted accordingly.

Liver Dose Adjustments

No adjustment recommended.

Precautions

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 5 mL/min or less: 0.94 g IV every 48 hours

Comments: Both components are hemodialyzable; this drug should be administered after hemodialysis on hemodialysis days.

Other Comments

Administration advice:
-Reserve this drug for use in patients with limited or no alternative treatment options.
-Administer 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.
-Constituted solutions in the infusion bags: Should be used within 12 hours when stored at room temperature; may be refrigerated at 2C to 8C (36F to 46F) for up to 24 hours after constitution, 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:
-At concentrations between 0.008 g/mL ceftazidime (plus 0.002 g/mL avibactam) and 0.04 g/mL ceftazidime (plus 0.01 g/mL avibactam), this drug is compatible with more commonly used IV infusion fluids in infusions bags (such as the following).
-Compatible IV infusion fluids: 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; in Baxter(R) Mini-Bag Plus(TM) containing 0.9% sodium chloride injection or 5% dextrose injection
-Compatibility for administration with other drugs has not been established.

General:
-The dose is expressed as the total of ceftazidime content plus avibactam content; the 2.5 g dose corresponds to 2 g ceftazidime plus 0.5 g avibactam; the 1.25 g dose corresponds to 1 g ceftazidime plus 0.25 g avibactam; the 0.94 g dose corresponds to 0.75 g ceftazidime plus 0.19 g avibactam.
-To reduce the development of drug-resistant organisms, antibacterials should be used only to treat infections proven/strongly suspected to be caused by susceptible bacteria.
-Culture and susceptibility information should be considered when selecting treatment 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)

Patient advice:
-Avoid missing doses and complete the entire course of therapy.