II. Indications
- Conditions
- Gram-Negative, Multi-drug resistant intraabdominal Infections and Urinary Tract Infections
-
Bacterial Coverage
- Pseudomonas aeruginosa (Main indication)
- EKP Gram Negative Bacteria (Escherichia coli, Klebsiella, Proteus)
- ESP Gram Negative Bacteria (Enterobacter, Serratia, Providencia)
- Also covers Citrobacter species
- Gram Positive Cocci poorly covered
- No Gram Negative Coccobacilli coverage
III. Pharmacokinetics
- Half-Life Ceftazidime: 2.7 hours (similar for Avibactam)
- Ceftazidime is excreted in urine (80-90% unchanged, avibactam is 100% unchanged on excretion)
- Adjust dose in Renal Failure
IV. Medications
-
Ceftazidime (Fortaz)
- Adult: 1-2 grams IM or IV every 8 to 12 hours
- Child: 30-50 mg/kg IV every 8 hours
-
Ceftazidime-Avibactam (Zavicefta)
- Addition of Beta-Lactamase inhibitor (Avibactam) circumvents Beta-Lactamase resistance
- Ceftazidime-Avibactam (2g-0.5g) 2.5 g IV every 8 hours
- Urinary Tract Infections: Treated for 7-14 days
- Intraabdominal infections
- Treat for 5 to 14 days
- Combine with Metronidazole
V. Precautions
- Avoid Avibactam in pregnancy (adverse effects in pregnancy)
- Ceftazidime is excreted in Breast Milk
VI. Disadvantages
- Most expensive
- Limited spectrum
VII. Adverse Effects
- Gastrointestinal (Nausea, Vomiting, Diarrhea, Constipation)
- Dizziness
- Anxiousness
- Abdominal Pain
- Paresthesias
VIII. References
- Morrison and LoVecchio (2021) Crit Dec Emerg Med 35(1): 28