Ceftazidime/avibactam: a novel cephalosporin/nonbeta-lactam beta-lactamase inhibitor for the treatment of complicated urinary tract infections and complicated intra-abdominal infections

Drug Des Devel Ther. 2016 Jul 26:10:2379-86. doi: 10.2147/DDDT.S110946. eCollection 2016.

Abstract

There has been greater interest in developing additional antimicrobial agents due to the increasing health care costs and resistance resulting from bacterial pathogens to currently available treatment options. Gram-negative organisms including Enterobacteriaceae and Pseudomonas aeruginosa are some of the most concerning threats due to their resistance mechanisms: extended-spectrum beta-lactamase production and Klebsiella pneumoniae carbapenemase enzymes. Ceftazidime is a third-generation broad-spectrum cephalosporin with activity against P. aeruginosa and avibactam is a novel nonbeta-lactam beta-lactamase inhibitor. Avycaz(®), the trade name for this new combination antibiotic, restores the activity of ceftazidime against some of the previously resistant pathogens. Avycaz was approved in 2015 for the treatment of complicated urinary tract infections, including pyelonephritis, and complicated intra-abdominal infections with the addition of metronidazole in patients with little to no other treatment options. This review article assesses the clinical trials and data that led to the approval of this antibiotic, in addition to its spectrum of activity and limitations.

Keywords: Avycaz; ceftazidime/avibactam; complicated intra-abdominal infections; complicated urinary tract infections.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Azabicyclo Compounds / administration & dosage
  • Azabicyclo Compounds / pharmacology
  • Azabicyclo Compounds / therapeutic use*
  • Ceftazidime / administration & dosage
  • Ceftazidime / pharmacology
  • Ceftazidime / therapeutic use*
  • Cephalosporinase / metabolism
  • Humans
  • Intraabdominal Infections / complications
  • Intraabdominal Infections / drug therapy*
  • Intraabdominal Infections / microbiology
  • Klebsiella pneumoniae / drug effects
  • Urinary Tract Infections / complications
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / microbiology
  • beta-Lactamase Inhibitors / administration & dosage
  • beta-Lactamase Inhibitors / pharmacology
  • beta-Lactamase Inhibitors / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Azabicyclo Compounds
  • beta-Lactamase Inhibitors
  • avibactam
  • Ceftazidime
  • Cephalosporinase