Products
Avibactam was approved in the United States in 2015, in the EU in 2016, and in many countries in 2019 in fixed combination with the cephalosporin ceftazidime as a powder for a concentrate for solution for infusion (Zavicefta).
Structure and properties
Avibactam (C7H11N3O6S, Mr = 265.25 g/mol), unlike other beta-lactamase inhibitors, is not itself a beta-lactam but has structural similarities.
Effects
Avibactam (ATC J01DD52) is not itself antibacterial. It is a potent inhibitor of beta-lactamases involved in the development of resistance to ceftazidime and other beta-lactam antibiotics. Avibactam has a broad spectrum of activity. The effects are based on covalent and reversible binding to the enzymes. Avibactam is excreted unchanged in the urine and has a half-life of approximately two hours.
Indications
In combination with ceftazidime for the treatment of bacterial infectious diseases:
- Complicated intra-abdominal infections (cIAI).
- Complicated urinary tract infections (cUTI), including pyelonephritis.
- Nosocomial pneumonias (HAP), including ventilator-associated pneumonia (VAP).
- For the treatment of infections due to aerobic gram-negative pathogens in adult patients with limited treatment options.
Dosage
According to the professional information. The drug is administered as an intravenous infusion.
Contraindications
For complete precautions, see the drug label.
Interactions
Avibactam is a substrate of OAT1 and OAT3. In contrast, it does not interact with CYP450 isozymes.
Adverse effects
The most common potential adverse effects of combination therapy include a positive direct Coombs test, nausea, and diarrhea.
