Cephalosporins類抗生素 (三四代)

Intra-abdominal infections, complicated: In adult and pediatric patients ≥3 months of age, in combination with metronidazole; caused by E. cloacae, E. coli, K. oxytoca, K. pneumoniae, P. mirabilis, and P. aeruginosa
Pneumonia, hospital-acquired and ventilator-associated: In adult patients caused by K. pneumoniae, E. cloacae, E. coli, Serratia marcescens, P. mirabilis, P. aeruginosa, and H. influenzae
Urinary tract infections, complicated (including pyelonephritis): 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

Antibiotic,Cephalosporins+ beta-lactamases inhibitor

Distribution
1. Vd: (Ceftazidime) 17-18.1 L; (Avibactam) 22.2-23.2 L
2. Protein binding: (Ceftazidime) <10%; (Avibactam) 5.7% to 8.2%
Metabolism:
1. Ceftazidime: ~80% to 90% of dose eliminated as unchanged drug
2. Avibactam: Not metabolized
Half-life elimination:
1. Ceftazidime: (Children and Adolescents) 1.6-1.7 hours; (Adults) 2.76-3.27 hours
10 Avibactam: (Children and Adolescents) 1.6-1.7 hours; (Adults) 2.22-2.71 hours
Excretion:
1. Ceftazidime: Urine (~80% to 90% as unchanged drug)
2. Avibactam: Urine (97%)

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

Adverse events have not been observed in animal reproduction studies conducted with ceftazidime and avibactam.

Ceftazidime is excreted in breast milk. It is not known if avibactam is excreted in breast milk.
The decision to continue or discontinue breast-feeding during therapy should take into account the risk and the benefits.

1. Hematologic & oncologic: Positive direct coombs test
2. Dermatologic: Injection site phlebitis, skin rash, pruritus
3. Gastrointestinal: Vomiting, diarrhea, nausea, constipation, upper abdominal pain

Intra-abdominal infections, complicated:
2.5 g every 8 hours in combination with metronidazole for 4-5 days
Pneumonia, hospital-acquired and ventilator-associated (HAP/VAP):
2.5 g every 8 hours for 7 days
Urinary tract infections, complicated (including pyelonephritis):
2.5 g every 8 hours for 5 to 14 days

Intra-abdominal infections, complicated:
(Use in combination with metronidazole; treat for 5 to 14 days depending upon severity and clinical response)
1. Infants 3-6 months: 40 mg ceftazidime/kg/dose every 8 hours.
2. 6 months-18 years: 50 mg ceftazidime/kg/dose every 8 hours; maximum 2,000 mg ceftazidime/dose.
Urinary tract infections, complicated (including pyelonephritis):
(Treat for 7 to 14 days depending upon severity and clinical response)
1. Infant 3-6 months: 40 mg ceftazidime/kg/dose every 8 hours.
2. 6 months-18 years: 50 mg ceftazidime/kg/dose every 8 hours; maximum 2,000 mg ceftazidime/dose.
Pneumonia, hospital-acquired and ventilator-associated (HAP/VAP):
Adolescents ≥18 years: 2,000 mg ceftazidime every 8 hours for 7 to 14 days

Altered kidney function:
1. CrCl >50 mL/min: No dosage adjustment necessary
2. CrCl 31-50 mL/min: 1.25 g every 8 hours
3. CrCl 16-30 mL/min: 0.94 g every 12 hours
4. CrCl 6 to 15 mL/min: 0.94 g every 24 hours
5. CrCl <5 mL/min: 0.94 g every 48 hours
Hemodialysis, intermittent (thrice weekly):
Note: Dialyzable (~55% [based on a ceftazidime 1 g dose and avibactam 100 mg dose])
0.94 g every 24 to 48 hours depending on patient's residual kidney function; when scheduled dose falls on a dialysis day, administer after hemodialysis
CRRT:
1.25 g every 8 hours

No dosage adjustment necessary.