9/12/22, 6:52 PM Ceftazidime and avibactam: Drug information - UpToDate

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Ceftazidime and avibactam: Drug information

Copyright 1978-2022 Lexicomp, Inc. All rights reserved.

Contributor Disclosures

(For additional information see "Ceftazidime and avibactam: Patient drug information" and see "Ceftazidime
and avibactam: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp ( show table)

Brand Names: US
Avycaz

Pharmacologic Category
Cephalosporin Combination

Dosing: Adult
Note: Dosage recommendations are expressed as total grams of the ceftazidime/avibactam
combination. Not recommended for routine empiric use. Reserve use for patients with or at
risk for certain extensively drug-resistant gram-negative pathogens (nonsusceptible to ≥1
agent in all but 2 or fewer antimicrobial classes) (eg, carbapenem-resistant Enterobacterales,
extensively drug-resistant P. aeruginosa) (IDSA [Tamma 2021]; Magiorakos 2012; Yahav 2020).
Collapse All

Intra-abdominal infections 

Intra-abdominal infections (alternative agent):

IV: 2.5 g every 8 hours in combination with metronidazole (Mazuski 2016; SIS
[Mazuski 2017]). Total duration of therapy (which may include transition to oral
antibiotics) is 4 to 5 days following adequate source control (Gomi 2018; Sawyer
2015; SIS [Mazuski 2017]).

Pneumonia, hospital-acquired or ventilator-associated 

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Pneumonia, hospital-acquired or ventilator-associated (alternative agent): IV: 2.5

g every 8 hours (Torres 2018). Duration of therapy varies based on disease severity
and response to therapy; treatment is typically given for 7 days (IDSA/ATS [Kalil 2016]).

Urinary tract infection, complicated 

Urinary tract infection, complicated (pyelonephritis or urinary tract infection

with systemic signs/symptoms):

IV: 2.5 g every 8 hours (IDSA [Tamma 2021]; Wagenlehner 2016). Switch to an
appropriate oral regimen once symptoms improve, if culture and susceptibility
results allow. Total duration of therapy ranges from 5 to 14 days and depends on
clinical response and the antimicrobial chosen to complete the regimen (Hooton
2021).

Dosage adjustment for concomitant therapy: Significant drug interactions exist,

requiring dose/frequency adjustment or avoidance. Consult drug interactions database
for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical
expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts,
PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Note: Dosage recommendations are expressed as total grams of the

ceftazidime/avibactam combination.

Altered kidney function (Li 2019; manufacturer’s labeling):

Note: Estimation of renal function for the purpose of drug dosing should be done
using the Cockcroft-Gault formula.

IV:

CrCl >50 to <130 mL/minute: No dosage adjustment necessary.

CrCl >30 to 50 mL/minute: 1.25 g every 8 hours.

CrCl >15 to 30 mL/minute: 0.94 g every 12 hours.

CrCl >5 to 15 mL/minute: 0.94 g every 24 hours.

CrCl ≤5 mL/minute: 0.94 g every 48 hours.

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Augmented renal clearance (measured urinary CrCl ≥130 mL/minute/1.73 m2):

Note: Augmented renal clearance (ARC) is a condition that occurs in certain critically
ill patients without organ dysfunction and with normal serum creatinine
concentrations. Young patients (<55 years of age) admitted post trauma or major
surgery are at highest risk for ARC, as well as those with sepsis, burns, or
hematologic malignancies. An 8- to 24-hour measured urinary CrCl is necessary to
identify these patients (Bilbao-Meseguer 2018; Udy 2010).

IV: 2.5 g every 8 hours (Das 2019; Gatti 2021; Li 2020; Stein 2019).

Hemodialysis, intermittent (thrice weekly): Dialyzable (~57% ceftazidime; 55%

avibactam [Merdjan 2017; Pistolesi 2019; manufacturer’s labeling]): 0.94 g every 24
hours; in patients with minimal residual kidney function and less severe infections, may
consider administering 0.94 g every 48 hours. When scheduled dose falls on a dialysis
day, administer after hemodialysis (expert opinion; manufacturer’s labeling).

Peritoneal dialysis:

IV: 0.94 g every 24 hours; in patients with minimal residual kidney function and less
severe infections, may consider administering 0.94 g every 48 hours (expert
opinion).

CRRT:

Note: Drug clearance is dependent on the effluent flow rate, filter type, and method
of renal replacement. Recommendations are based on high-flux dialyzers and
effluent flow rates of 20 to 25 mL/kg/hour (or ~1,500 to 3,000 mL/hour) unless
otherwise noted. Appropriate dosing requires consideration of adequate drug
concentrations (eg, site of infection). Close monitoring of response and adverse
reactions (eg, neurotoxicity) due to drug accumulation is important.

IV: 1.25 g every 8 hours (Pistolesi 2019; Wenzler 2017).

PIRRT (eg, sustained, low-efficiency diafiltration):

Note: Drug clearance is dependent on the effluent flow rate, filter type, and method
of renal replacement. Appropriate dosing requires consideration of adequate drug
concentrations (eg, site of infection). Close monitoring of response and adverse
reactions (eg, neurotoxicity) due to drug accumulation is important.

IV:

On PIRRT days: 1.25 g every 12 hours (administer 1 of the twice-daily doses

after PIRRT session). Patients receiving prolonged daily treatments (eg, 12

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hours a day) may require dosing every 8 hours (expert opinion).

On non-PIRRT days: Dose as for CrCl ≤15 mL/minute (expert opinion).

Dosing: Hepatic Impairment: Adult

No dosage adjustment necessary.

Dosing: Pediatric

(For additional information see "Ceftazidime and avibactam: Pediatric drug information")
Note: Avycaz (ceftazidime and avibactam) is a combination product; each 2.5 g vial contains
2 g ceftazidime and 0.5 g avibactam sodium in a 4:1 ratio. Dosage recommendations are
based on the ceftazidime component. Dosing presented is based on traditional infusion
method (IV infusion over 2 hours).

Intra-abdominal infections, complicated (cIAI): Note: Use in combination with

metronidazole; treat for 5 to 14 days depending upon severity and clinical response:

Infants ≥3 months to <6 months: IV: 40 mg ceftazidime/kg/dose every 8 hours.

Infants ≥6 months, Children, and Adolescents <18 years: IV: 50 mg

ceftazidime/kg/dose every 8 hours; maximum dose: 2,000 mg ceftazidime/dose.

Adolescents ≥18 years: 2,000 mg ceftazidime every 8 hours.

Urinary tract infections, complicated (cUTI) (including pyelonephritis): Note: Treat

for 7 to 14 days depending upon severity and clinical response:

Infant ≥3 months to <6 months: IV: 40 mg ceftazidime/kg/dose every 8 hours.

Infants ≥6 months, Children, and Adolescents <18 years: IV: 50 mg

ceftazidime/kg/dose every 8 hours; maximum dose: 2,000 mg ceftazidime/dose.

Adolescents ≥18 years: 2,000 mg ceftazidime every 8 hours.

Pneumonia, hospital-acquired and ventilator-associated (HAP/VAP): Adolescents ≥18

years: IV: 2,000 mg ceftazidime every 8 hours for 7 to 14 days.

Dosage adjustment for concomitant therapy: Significant drug interactions exist,

requiring dose/frequency adjustment or avoidance. Consult drug interactions database
for more information.

Dosing: Kidney Impairment: Pediatric

Note: Dosage recommendations are based on the ceftazidime component.

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Infants ≥3 months and Children <2 years: There are no dosage adjustments provided in
the manufacturer's labeling; insufficient data to provide any recommendations for use
in patients with eGFR <50 mL/minute/1.73 m2; use with caution.

Children ≥2 years and Adolescents <18 years: IV: Note: Use bedside Schwartz formula to
estimate renal function for the purpose of drug dosing.

eGFR >50 mL/minute/1.73 m2: No dosage adjustment necessary.

eGFR 31 to 50 mL/minute/1.73 m2: 25 mg ceftazidime/kg/dose every 8 hours;

maximum dose: 1,000 mg ceftazidime/dose.

eGFR 16 to 30 mL/minute/1.73 m2: 19 mg ceftazidime/kg/dose every 12 hours;

maximum dose: 750 mg ceftazidime/dose.

eGFR 6 to 15 mL/minute/1.73 m2: 19 mg ceftazidime/kg/dose every 24 hours;

maximum dose: 750 mg ceftazidime/dose.

eGFR ≤5 mL/minute/1.73 m2: 19 mg ceftazidime/kg/dose every 48 hours; maximum

dose: 750 mg ceftazidime/dose.

End-stage renal disease (ESRD) on intermittent hemodialysis (IHD): Administer after

hemodialysis on dialysis days; base dose upon patient's estimated renal function
(eg, eGFR 6 to 15 mL/minute/1.73 m2 or eGFR ≤5 mL/minute/1.73 m2).
Approximately 55% (based on a ceftazidime 1,000 mg dose and avibactam 100 mg
dose) is removed following a 4-hour dialysis session.

Adolescents ≥18 years: IV: Note: Use Cockcroft-Gault formula to estimate renal function
for the purpose of drug dosing.

CrCl >50 mL/minute: No dosage adjustment necessary.

CrCl 31 to 50 mL/minute: 1,000 mg ceftazidime every 8 hours.

CrCl 16 to 30 mL/minute: 750 mg ceftazidime every 12 hours.

CrCl 6 to 15 mL/minute: 750 mg ceftazidime every 24 hours.

CrCl ≤5 mL/minute: 750 mg ceftazidime every 48 hours.

End-stage renal disease (ESRD) on intermittent hemodialysis (IHD): Administer after

hemodialysis on dialysis days; base dose upon patient's estimated renal function
(eg, CrCl 6 to 15 mL/minute or CrCl ≤5 mL/minute). Approximately 55% (based on a
ceftazidime 1,000 mg dose and avibactam 100 mg dose) is removed following a 4-
hour dialysis session.

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Dosing: Hepatic Impairment: Pediatric

Infants ≥3 months, Children, and Adolescents: No dosage adjustment necessary.

Dosing: Older Adult

Refer to adult dosing.

Dosage Forms: US
Excipient information presented when available (limited, particularly for generics); consult
specific product labeling.

Solution Reconstituted, Intravenous [preservative free]:

Avycaz: Ceftazidime 2 g and avibactam 0.5 g (1 ea)

Generic Equivalent Available: US

No

Administration: Adult
IV: Administer by intermittent infusion over 2 hours.

Administration: Pediatric
IV: Administer by intermittent IV infusion over 2 hours.

Use: Labeled Indications

Intra-abdominal infections: Treatment of complicated intra-abdominal infections (cIAI)

in adult and pediatric patients ≥3 months of age, in combination with metronidazole,
caused by Citrobacter freundii complex, Enterobacter cloacae, Escherichia coli, Klebsiella
oxytoca, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa.

Pneumonia, hospital-acquired and ventilator-associated: Treatment of hospital-

acquired bacterial pneumonia and ventilator-associated (HAP/VAP) bacterial pneumonia
in adult patients caused by ceftazidime/avibactam-susceptible K. pneumoniae, E. cloacae,
E. coli, Serratia marcescens, P. mirabilis, P. aeruginosa, and Haemophilus influenzae.

Urinary tract infection, complicated (pyelonephritis or urinary tract infection with

systemic signs/symptoms): Treatment of complicated urinary tract infections
(including pyelonephritis) in adult and pediatric patients ≥3 months of age, caused by C.
freundii complex, E. cloacae, E. coli, K. pneumoniae, P. mirabilis, and P. aeruginosa.

Adverse Reactions
The following adverse drug reactions and incidences are derived from product labeling
unless otherwise specified. Also see ceftazidime monograph.
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>10%: Hematologic & oncologic: Positive direct coombs test (3% to 21%)

1% to 10%:

Dermatologic: Injection site phlebitis (children and adolescents: >3%; adults: <1%),
skin rash (children and adolescents: >3%; adults: <1%), pruritus (2%)

Gastrointestinal: Vomiting (>3%), diarrhea (≥3%), nausea (3%), constipation (2%),

upper abdominal pain (1%)

<1%, postmarketing, and/or case reports: Acute renal failure, anxiety, candidiasis,
Clostridioides difficile-associated diarrhea, dysgeusia, hypokalemia, increased gamma-
glutamyl transferase, increased serum alanine aminotransferase, increased serum
aspartate aminotransferase, leukopenia, maculopapular rash, nephrolithiasis, renal
insufficiency, thrombocythemia, thrombocytopenia, urticaria

Contraindications
Known serious hypersensitivity to ceftazidime, avibactam, other cephalosporins, or any
component of the formulation

Warnings/Precautions

Concerns related to adverse effects:

• Hypersensitivity reactions: Serious and occasionally severe or fatal hypersensitivity

(anaphylactic) reactions and serious skin reactions have been reported in patients
receiving beta-lactam drugs. Before initiating therapy, carefully investigate previous
penicillin, cephalosporin, or carbapenem hypersensitivity. Use caution if given to a
patient with a penicillin or other beta-lactam allergy; cross sensitivity has been
established. If an allergic reaction occurs, discontinue and institute appropriate
management.

• Neurotoxicity: Severe neurological reactions have been reported with ceftazidime,

including asterixis, coma, encephalopathy, myoclonus, neuromuscular excitability,
seizures, and nonconvulsive status epilepticus. Risk may be increased in the
presence of renal impairment; ensure dose adjusted for renal function. Discontinue
therapy if patient develops neurotoxicity.

• Superinfection: Prolonged use may result in fungal or bacterial superinfection,

including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis;
CDAD has been observed >2 months postantibiotic treatment.

Disease-related concerns:

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• Renal impairment: In a complicated intra-abdominal infection clinical trial, adult

patients with a CrCl of 30 to 50 mL/minute had lower clinical cure rates than those
with CrCl >50 mL/minute; however, these patients received a daily dose that was
33% lower than what is currently recommended for patients with this degree of
renal impairment. Decreased clinical response was not seen in patients with a
baseline CrCl of 30 to 50 mL/minute in complicated UTI clinical trials. Monitor renal
function at baseline and at least daily in adult and pediatric patients with changing
renal function. Adjust the dose accordingly.

Metabolism/Transport Effects
Refer to individual components.

Drug Interactions
(For additional information: Launch drug interactions program)

Note: Interacting drugs may not be individually listed below if they are part of a group
interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a
complete list of drug interactions by individual drug name and detailed management
recommendations, use the Lexicomp drug interactions program by clicking on the “Launch
drug interactions program” link above.

Aminoglycosides: Cephalosporins may enhance the nephrotoxic effect of

Aminoglycosides. Cephalosporins may decrease the serum concentration of
Aminoglycosides. Risk C: Monitor therapy

Bacillus clausii: Antibiotics may diminish the therapeutic effect of Bacillus clausii.
Management: Bacillus clausii should be taken in between antibiotic doses during
concomitant therapy. Risk D: Consider therapy modification

BCG (Intravesical): Antibiotics may diminish the therapeutic effect of BCG (Intravesical).
Risk X: Avoid combination

BCG Vaccine (Immunization): Antibiotics may diminish the therapeutic effect of BCG
Vaccine (Immunization). Risk C: Monitor therapy

Chloramphenicol (Systemic): May diminish the therapeutic effect of CefTAZidime.

Management: Consider using a different combination of antimicrobials, especially if
bactericidal activity is desired. If these agents are combined, monitor for reduced
antimicrobial effectiveness and/or therapeutic failure. Risk D: Consider therapy
modification

Cholera Vaccine: Antibiotics may diminish the therapeutic effect of Cholera Vaccine.
Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and

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within 14 days following the use of oral or parenteral antibiotics. Risk X: Avoid
combination

Immune Checkpoint Inhibitors: Antibiotics may diminish the therapeutic effect of

Immune Checkpoint Inhibitors. Risk C: Monitor therapy

Lactobacillus and Estriol: Antibiotics may diminish the therapeutic effect of Lactobacillus
and Estriol. Risk C: Monitor therapy

Probenecid: May increase the serum concentration of Avibactam. Risk X: Avoid

combination

Sodium Picosulfate: Antibiotics may diminish the therapeutic effect of Sodium

Picosulfate. Management: Consider using an alternative product for bowel cleansing
prior to a colonoscopy in patients who have recently used or are concurrently using an
antibiotic. Risk D: Consider therapy modification

Typhoid Vaccine: Antibiotics may diminish the therapeutic effect of Typhoid Vaccine.
Only the live attenuated Ty21a strain is affected. Management: Avoid use of live
attenuated typhoid vaccine (Ty21a) in patients being treated with systemic antibacterial
agents. Postpone vaccination until 3 days after cessation of antibiotics and avoid
starting antibiotics within 3 days of last vaccine dose. Risk D: Consider therapy
modification

Vitamin K Antagonists (eg, warfarin): Cephalosporins may enhance the anticoagulant

effect of Vitamin K Antagonists. Risk C: Monitor therapy

Pregnancy Considerations
Adverse events have not been observed in animal reproduction studies conducted with
ceftazidime; adverse events have been observed in some animal reproduction studies
conducted with avibactam.

Breastfeeding Considerations
Ceftazidime is excreted in breast milk. It is not known if avibactam is excreted in breast milk.
According to the manufacturer, the decision to continue or discontinue breast-feeding
during therapy should take into account the risk of infant exposure, the benefits of breast-
feeding to the infant, and benefits of treatment to the mother.

Monitoring Parameters
Monitor for signs of anaphylaxis during first dose. Monitor renal function at baseline in all
patients, and at least daily in patients with changing renal function.

Mechanism of Action

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Ceftazidime inhibits bacterial cell wall synthesis by binding to one or more of the
penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of
peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis.
Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins
and murein hydrolases) while cell wall assembly is arrested.

Avibactam inactivates some beta-lactamases and protects ceftazidime from

degradation.

Pharmacokinetics

Distribution: Vd:

Single dose: Adults: Mean: Ceftazidime: 18.1 L; Avibactam: 23.2 L

Multiple dose: Adults: Mean: Ceftazidime: 17 L; Avibactam: 22.2 L

Protein binding: Ceftazidime: <10%; Avibactam: 5.7% to 8.2%

Metabolism: Ceftazidime: ~80% to 90% of dose eliminated as unchanged drug;

Avibactam: Not metabolized

Half-life elimination:

Single dose:

Ceftazidime:

Children ≥6 years to <12 years: Median: 1.6 hours (0.9 to 1.8 hours) (Bradley
2016)

Children ≥12 years and Adolescents: Median: 1.7 hours (0.9 to 2.8 hours)
(Bradley 2016)

Adults: Mean: 3.27 hours

Avibactam:

Children ≥6 years to <12 years: Median: 1.7 hours (0.9 to 2 hours) (Bradley
2016)

Children ≥12 years and Adolescents: Median: 1.6 hours (0.9 to 2.8 hours)
(Bradley 2016)

Adults: Mean: 2.22 hours

Multiple dose: Adults: Mean: Ceftazidime: 2.76 hours; Avibactam: 2.71 hours

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Excretion: Ceftazidime: Urine (~80% to 90% as unchanged drug); Avibactam: Urine (97%)

Pharmacokinetics: Additional Considerations

Altered kidney function: Half-life increases in patients with impaired renal function; AUC
of avibactam increases 2.6-fold, 3.8-fold, and 7-fold in patients with mild, moderate or
severe renal impairment, respectively.

Anti-infective considerations:

Parameters associated with efficacy:

Ceftazidime (data on monotherapy for susceptible organisms): Time dependent;

associated with time free drug concentration (fT) > minimum inhibitory
concentration (MIC):

Organism specific: Gram-negative bacteria (including P. aeruginosa): Goal:

35% to 40% fT > MIC (bacteriostatic in vitro); 60% to 70% fT > MIC
(bactericidal in vitro); ~45% to 53% fT > MIC (microbiological response)
(Craig 1995; MacVane 2014; Muller 2013).

Population specific: In critically ill patients in the ICU, minimum goal: ≥50%
fT > MIC; preferred goal: ≥100% fT > MIC (Abdul-Aziz 2020; Al-Shaer 2020;
Roberts 2014); some experts favor ≥100% fT >4 times the MIC (Guilhaumou
2019).

Ceftazidime (in combination with avibactam): Interrelationship between

ceftazidime exposure, avibactam exposure, MIC, and efficacy is not fully
elucidated; at avibactam exposures that were associated with bacteriostatic and
bactericidal activity, mean ceftazidime fT > MIC (ceftazidime MIC in the presence
of a fixed avibactam concentration): ~50% (Berkhout 2015; Nichols 2018).

Avibactam (in combination with ceftazidime): Time dependent, associated with

fT > threshold concentration (threshold concentration: 1 mg/L); goal: ≥ ~20% to
50% (Berkhout 2015; Coleman 2014; Crass 2019; Nichols 2018).

Postantibiotic effect: Generally little to no postantibiotic effect (Berkhout 2021; Pillar

2016).

Expected drug concentrations in patients with normal renal function:

Pediatric patients (hospitalized): Single dose (2-hour infusion): Cmax (peak): IV:

Infants and children 3 months to <2 years of age: Ceftazidime 50

mg/avibactam 12.5 mg per kg: Ceftazidime: 91.7 mg/L; Avibactam: 16.3

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mg/L (Bradley 2016).

Children 2 to <12 years of age: Ceftazidime 50 mg/avibactam 12.5 mg per

kg (maximum ceftazidime 2,000 mg/avibactam 500 mg): Ceftazidime: ~80
mg/L; Avibactam: ~14 mg/L (Bradley 2016).

Children and adolescents 12 to <18 years of age: Ceftazidime 2,000

mg/avibactam 500 mg: Ceftazidime: 79.8 mg/L; Avibactam: 15.1 mg/L
(Bradley 2016).

Adults: Cmax (peak): IV:

Note: Adult doses are expressed as the combined amount of ceftazidime

and avibactam.

Single dose, 30-minute infusion (healthy volunteers): 2.5 g: Ceftazidime:

93.17 mg/L; Avibactam: 23.33 mg/L (Merdjan 2015).

Steady state, 30-minute infusion (healthy volunteers): 2.5 g every 8 hours:

Ceftazidime: 114.53 mg/L; Avibactam: 22.22 mg/L (Merdjan 2015).

Steady state, 2-hour infusion (patients with nosocomial pneumonia,

including ventilator-associated): 2.5 g every 8 hours: Ceftazidime: 61.9 to 79
mg/L; Avibactam: 12 to 15.5 mg/L (Li 2019).

Pricing: US

Solution (reconstituted) (Avycaz Intravenous)

2.5 (2-0.5) g (per each): $430.57

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided
as reference price only. A range is provided when more than one manufacturer's AWP price
is available and uses the low and high price reported by the manufacturers to determine the
range. The pricing data should be used for benchmarking purposes only, and as such should
not be used alone to set or adjudicate any prices for reimbursement or purchasing functions
or considered to be an exact price for a single product and/or manufacturer. Medi-Span
expressly disclaims all warranties of any kind or nature, whether express or implied, and
assumes no liability with respect to accuracy of price or price range data published in its
solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or
consequential damages arising from use of price or price range data. Pricing data is updated
monthly.

Brand Names: International

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Zavicefta (AT, BE, DE, DK, EE, FI, GB, HR, IE, IL, NL, NO, PL, SE, TH, TW)

For country abbreviations used in Lexicomp ( show table)

Use of UpToDate is subject to the Terms of Use.

REFERENCES

1. Abdul-Aziz MH, Alffenaar JC, Bassetti M, et al; Infection Section of European Society of Intensive Care Medicine
(ESICM); Pharmacokinetic/pharmacodynamic and critically ill patient study groups of European Society of
Clinical Microbiology and Infectious Diseases (ESCMID); Infectious Diseases Group of International Association
of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT); Infections in the ICU and Sepsis Working
Group of International Society of Antimicrobial Chemotherapy (ISAC). Antimicrobial therapeutic drug
monitoring in critically ill adult patients: a position paper. Intensive Care Med. 2020;46(6):1127-1153.
doi:10.1007/s00134-020-06050-1 [PubMed 32383061]

2. Al-Shaer MH, Rubido E, Cherabuddi K, Venugopalan V, Klinker K, Peloquin C. Early therapeutic monitoring of
β-lactams and associated therapy outcomes in critically ill patients. J Antimicrob Chemother.
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