Zavicefta is a fixed-dose combination of Ceftazidime, a third-generation cephalosporin that inhibits bacterial cell wall synthesis by binding penicillin-binding proteins, and Avibactam, a beta-lactamase inhibitor that covalently binds and inactivates class A, C, and some D beta-lactamases, restoring Ceftazidime’s activity against resistant strains. This broad-spectrum agent targets multidrug-resistant Gram-negative infections, including those caused by KPC-producing Enterobacterales and Pseudomonas aeruginosa, with efficacy demonstrated in REPROVE and RECLAIM trials for cIAI and cUTI.
Key Benefits:
- Effective against beta-lactamase-producing Gram-negative pathogens
- Suitable for complicated intra-abdominal, urinary, and respiratory infections
- Pediatric dosing available from birth in approved indications
- Reduced resistance breakthrough compared to monotherapy
- Compatible with metronidazole for polymicrobial coverage
How to Use
- Administration: Intravenous infusion only; reconstitute powder with 10ml sterile water, then dilute in 100ml compatible fluid (e.g., 0.9% NaCl). Infuse over 2 hours every 8 hours.
- Dosage: Adults: 2.5g (2g/0.5g) IV q8h. Adjust for renal impairment (e.g., CrCl 31-50ml/min: q12h). Pediatrics: Weight-based from birth (e.g., 62.5mg/kg q8h for <2 years).
- Timing: Every 8 hours; consistent intervals for steady-state.
- Preparation: Inspect for particles/discoloration post-reconstitution; discard if present.
- Duration: 5-14 days based on infection; complete full course.
Expert Tips from CureCart Direct:
- Administer after hemodialysis on dialysis days.
- Use dedicated IV line; incompatible with some solutions (e.g., Ringer’s lactate).
- Monitor renal function; adjust for CrCl <50ml/min.
- Store unopened at room temperature; reconstituted stable 8 hours at room temp.
- Home use: Professional training required; not for IM/SC.
Missed Dose: Administer ASAP if within interval; resume schedule—do not double.
Overdose: Enhanced side effects (e.g., seizures, encephalopathy); hemodialysis removes both components—seek emergency care.
Primary Uses
- Treatment of complicated intra-abdominal infections (cIAI).
- Complicated urinary tract infections (cUTI), including pyelonephritis.
- Hospital-acquired/ventilator-associated bacterial pneumonia (HABP/VABP).
Indications
Used in adults and pediatrics (from birth) for:
- cIAI (with/without metronidazole for anaerobes).
- cUTI including pyelonephritis.
- HABP/VABP in patients with limited alternatives.
Side Effects
Common:
- Diarrhea, nausea, vomiting
- Headache, pyrexia
- Injection site reactions
- Rash, pruritus
Less Common:
- Constipation, abdominal pain
- Dizziness, fatigue
Serious/Rare:
- Clostridioides difficile-associated diarrhea (severe colitis)
- Severe cutaneous reactions (SJS/TEN, DRESS, AGEP)
- Renal impairment, hepatic enzyme elevation
- Anaphylaxis, seizures (high doses)
Discontinue if severe rash or superinfection occurs.
Warnings and Precautions
- Pregnancy: Limited data; use if benefits outweigh risks—monitor newborn.
- Lactation: Low levels in milk; consider alternatives.
- Driving: Generally safe post-infusion; caution if dizziness.
- Renal Impairment: Dose adjust by CrCl; contraindicated if CrCl <10ml/min without dialysis.
- Hepatic Impairment: No adjustment; monitor LFTs.
- Allergies: Cross-reactivity with penicillins (~1-10%); test if history.
- Other: Risk of resistance development; reserve for confirmed susceptible infections. Avoid live vaccines; false-positive urine glucose. Hemodialysis patients: Administer post-dialysis.
Contraindications
Do not use in:
- Known hypersensitivity to Ceftazidime, Avibactam, cephalosporins, or beta-lactamase inhibitors.
- Severe allergic reactions to penicillins or carbapenems.
Drug Interactions
- Probenecid: Reduces clearance—not recommended.
- Live Vaccines (e.g., cholera, typhoid): May impair efficacy.
- Metronidazole: Compatible for anaerobes; no adjustment.
Minimal overall; inform of all antibiotics.
Storage/Disposal
Store unopened vials at room temperature (15-30°C), away from light/heat. Reconstituted: Stable 8 hours at room temp or 24 hours refrigerated. Discard unused. Do not freeze. Dispose via hazardous waste; pharmacist guidance—do not flush.
Doctor Review
Dr. Ayesha Khan, MBBS, FCPS – Infectious Disease Specialist “Zavicefta (ceftazidime/avibactam) restores cephalosporin efficacy against KPC and OXA-48 producers via avibactam’s diazabicyclooctane inhibition of serine beta-lactamases, achieving MIC90 <4mcg/ml for Enterobacterales in surveillance data. REPROVE trial noninferiority vs meropenem in cIAI (90% cure) underscores polymicrobial utility, with pediatric extension from birth via weight-based dosing (50mg/kg ceftazidime q8h). Renal clearance (85% unchanged) mandates CrCl adjustment, preventing accumulation in eGFR <50ml/min, while C. difficile risk (3-5%) requires diarrhea vigilance. Rare DRESS/SJS (0.1%) contraindicates re-challenge, positioning it as carbapenem-sparing in MDR Gram-negative stewardship.”
FAQs
Administration route? IV infusion only; over 2 hours q8h.
Renal dosing? Adjust for CrCl <50ml/min; post-hemodialysis.
Allergy risk? Cross with penicillins; test history.
C. diff risk? Yes; monitor diarrhea, discontinue if suspected.
Pediatric use? From birth; weight-based.
Related Tests: Renal function, LFTs, culture/sensitivity, CBC.
Quick Tips:
- Infuse slowly (2h).
- Inspect pre-use.
- Complete course.
- Hydrate well.
Disclaimer: This information is for educational purposes only and not a substitute for professional medical advice. Always consult a qualified physician before use. CureCart Direct ensures accurate details but cannot cover all interactions or precautions. Prices and availability subject to change.
Reviews
There are no reviews yet.