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Beta-Lactam / Beta-Lactamase Inhibitor (MDR Gram-Negative)

Ceftazidime / Avibactam

Brand names: Zavicefta

Ceftazidime/avibactam is a fixed intravenous combination of ceftazidime with the beta-lactamase inhibitor avibactam, used for serious multidrug-resistant Gram-negative infections including those caused by certain carbapenemase-producing Enterobacterales.

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 inhibits cell-wall synthesis via penicillin-binding proteins, and avibactam restores its activity by inhibiting many serine beta-lactamases including ESBLs, AmpC, KPC and some OXA-48-type enzymes, though it does not inhibit metallo-beta-lactamases.

Prescribing in practice

  • Reserve for confirmed or suspected resistant Gram-negative infection under specialist microbiology guidance, as it lacks activity against metallo-beta-lactamase producers and overuse drives resistance.
  • Contraindicated in severe hypersensitivity to ceftazidime, avibactam or other cephalosporins.
  • Both components are renally cleared and require dose adjustment in renal impairment, where under-dosing has been linked to treatment failure.

Monitoring

Monitor renal function closely to guide dosing, alongside clinical and microbiological response.

Counselling the patient

  • This is a reserved hospital intravenous antibiotic for resistant infections.
  • Report rash, diarrhoea, or breathing difficulty to the team.

Evidence & guidelines

Phase 3 trials including RECAPTURE, REPRISE and RECLAIM supported efficacy in complicated urinary and intra-abdominal infection caused by resistant Gram-negative organisms.

Reference: Carmeli et al. Lancet Infect Dis 2016 (RECLAIM); MHRA SPC Zavicefta; ECCMID CRE guidelines 2023; 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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