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Cephalosporin + beta-lactamase inhibitor

Ceftazidime with avibactam

Brand names: Zavicefta

Ceftazidime with avibactam is a fixed-dose intravenous antibiotic combining an anti-pseudomonal cephalosporin with the inhibitor avibactam, indicated for complicated intra-abdominal and urinary tract infections, hospital-acquired pneumonia and infections by aerobic Gram-negative organisms with limited treatment options.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Ceftazidime binds penicillin-binding proteins to disrupt cell-wall synthesis while avibactam protects it from hydrolysis by serine beta-lactamases such as ESBLs, AmpC, KPC and OXA-48-type enzymes; it has no activity against metallo-beta-lactamases.

Prescribing in practice

  • Use under specialist guidance for resistant Gram-negative infections, recognising it does not cover metallo-beta-lactamase-producing organisms, so susceptibility should guide therapy.
  • Avoid in significant hypersensitivity to either component or other cephalosporins, with caution in broader beta-lactam allergy.
  • Dose must be reduced in renal impairment as both components are renally eliminated.

Monitoring

Monitor renal function to guide dosing together with clinical and microbiological response and signs of Clostridioides difficile-associated diarrhoea.

Counselling the patient

  • This is a hospital intravenous antibiotic reserved for serious resistant infections.
  • Report new or worsening diarrhoea, rash, or breathing difficulty.
  • Mention any previous penicillin or cephalosporin allergy.

Evidence & guidelines

Its licensed indications are supported by the phase 3 RECLAIM, RECAPTURE and REPROVE trials in intra-abdominal, urinary and nosocomial pneumonia infections.

Reference: NICE TA836; BSAC; UKHSA AMR; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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