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Ceftazidime + avibactam (Zavicefta°). An option in the case of cephalosporin resistance

FEATURED REVIEW A ceftazidime + avibactam combination (Zavicefta°, Pfizer) has been approved in the European Union for the treatment of various “complicated” infections. In one clinical trial, the combination was as effective as a carbapenem and had an acceptable adverse effect profile.
Full review (2 pages) available for download by subscribers.

In practice

  • The ceftazidime + avibactam combination has not been compared with third-generation cephalosporins.
     
  • It is clinically effective in patients with infections due to bacteria that are resistant to ceftazidime in vitro.
     
  • Its adverse effect profile seems similar to that of ceftazidime monotherapy, but data on its co-administration with avibactam are sparse.
     
  • Although its evaluation is mainly restricted to patients with non-serious infections, this combination is an option for patients with infections due to bacteria resistant to cephalosporins, including ceftazidime, in order to limit the use of carbapenems. The optimal dose in patients with renal impairment is poorly established.
  •  POSSIBLY HELPFUL  In a clinical trial in about 300 patients, most of whom were infected with ceftazidime-resistant bacteria, the ceftazidime + avibactam combination was as effective as a carbapenem and had an acceptable adverse effect profile. Although most trials have not included patients with life-threatening infections, and despite the lack of head-to-head comparisons with third-generation cephalosporins, the ceftazidime + avibactam combination is an option for patients infected with bacteria resistant to cephalosporins, including ceftazidime, in order to limit the use of carbapenems.

 
©Prescrire 1 March 2018

"Ceftazidime + avibactam (Zavicefta°). An option in the case of cephalosporin resistance" Prescrire Int 2018; 27 (190): 66-67. (Pdf, subscribers only)

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 POSSIBLY HELPFUL