Indications
Avibactam is used together with the antibiotic Ceftazidime as a combination injection. The combination treats serious bacterial infections in adults and children, including complicated intra-abdominal infections (given with Metronidazole), complicated urinary tract infections including kidney infection, hospital-acquired pneumonia including ventilator-associated pneumonia, and other infections caused by gram-negative bacteria when treatment options are limited. It is a hospital medicine given by a doctor or nurse, and is reserved for infections likely to be resistant to other antibiotics.
How It Works
Many resistant bacteria make enzymes called beta-lactamases, which destroy antibiotics such as Ceftazidime. Avibactam is a beta-lactamase inhibitor: it binds to and blocks many of these enzymes, including some carbapenemases. Avibactam itself has little antibacterial action, but it protects Ceftazidime, which then kills the bacteria by damaging their cell wall.
Dosage and Administration
It is given as an infusion (slow drip) into a vein over about 2 hours, usually every 8 hours, in hospital. The dose and length of treatment are decided by the doctor according to the infection, body weight in children and kidney function. Doses are reduced in people with kidney impairment.
Interactions
Probenecid can reduce the removal of Avibactam and is not recommended together. Strong diuretics such as Furosemide or other medicines that may harm the kidneys, such as Aminoglycosides, may increase the risk of kidney problems. Like other antibiotics, it may reduce the effectiveness of live oral typhoid and cholera vaccines.
Contraindications
- Allergy to Avibactam, Ceftazidime or any cephalosporin antibiotic.
- Severe allergic reaction (such as anaphylaxis) to any other beta-lactam antibiotic, including penicillins or carbapenems.
Side Effects
Common effects include diarrhoea, nausea, vomiting, stomach pain, headache, dizziness, pain or swelling at the infusion site, raised liver tests, positive Coombs blood test and fungal infections such as thrush.
Medical staff watch for and treat serious reactions. Tell the nurse or doctor at once if you develop rash, swelling of the face or throat, difficulty breathing, severe or bloody diarrhoea (which can happen during or weeks after treatment), confusion or fits (more likely with kidney problems), or reduced urine.
Pregnancy and Lactation
Experience in pregnancy is limited; it is used only if the doctor decides the benefit outweighs the risk. Ceftazidime passes into breast milk in small amounts and it is not known if Avibactam does; the doctor will advise on breastfeeding.
Precautions and Warnings
- Tell the doctor about any previous antibiotic allergy.
- Kidney function is monitored and the dose adjusted.
- Use only for infections proven or strongly suspected to be caused by susceptible bacteria, to limit resistance.
- Contains sodium; relevant for people on a salt-restricted diet.
Overdose
Overdose, especially in kidney impairment, may cause nervous system effects such as confusion, fits or coma. It is managed in hospital; haemodialysis can remove the medicine.
Therapeutic Class
Beta-lactamase inhibitor, used with a third-generation cephalosporin antibiotic.
Storage
Store the unopened vials as directed on the pack, usually below 30°C in the original carton, protected from light. Prepared solutions are used within the time stated by the manufacturer. Kept by hospitals, out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.