Ceftazidime/Avibactam: A New Antibiotic for Gram-Negative Infections.

OBJECTIVE: To review the chemistry, pharmacology, microbiology, pharmacokinetics, pharmacodynamics, clinical efficacy, safety, dosing, and administration of ceftazidime/avibactam (CAZ/AVI).

DATA SOURCES: A search of PubMed using the terms "ceftazidime," "avibactam," "NXL104," and "AVE1330A" was performed. The manufacturer's website was also reviewed to further identify relevant information.

STUDY SELECTION: All English-language articles from 2004 to May 2015 appearing in these searches were reviewed for relevance to this paper. In addition, their bibliographies were reviewed to identify any articles not identified in the searches.

DATA SYNTHESIS: CAZ/AVI is a new cephalosporin β-lactamase inhibitor combination with a spectrum of activity targeted against Gram-negative organisms including Enterobacteriaceae and Pseudomonas aeruginosa. The dosing regimen is 2.5 g every eight hours administered via IV infusion over two hours for 5 to 14 days. The dosing regimen should be adjusted based on renal function. A phase II trial has demonstrated that clinical cure rates with CAZ/AVI plus metronidazole are comparable to those with meropenem in the treatment of adults with complicated intra-abdominal infections. Another phase II clinical trial has demonstrated that clinical cure rates with CAZ/AVI are comparable to those with imipenem/cilastatin for the treatment of adults with complicated urinary tract infections (cUTIs). CAZ/AVI has a side effect profile similar to that of cephalosporins and carbapenems.

CONCLUSION: CAZ/AVI has a favorable efficacy and safety profile in the treatment of adults with complicated intra-abdominal infections or cUTIs. Further research is needed to refine its role, particularly for the treatment of multi-drug-resistant Gram-negative infections.