AHFS Class:

8:12.06.12 Third Generation Cephalosporins

The fixed combination of ceftazidime-avibactam sodium is available as a powder in single-use vials containing 2.5 g (ceftazidime 2 g as the pentahydrate plus avibactam 0.5 g as the sodium salt).³⁰⁰⁴ Each vial also contains sodium carbonate 239.6 mg.³⁰⁰⁴

Each 2.5-g vial should be reconstituted with 10 mL of sterile water for injection, sodium chloride 0.9%, dextrose 5%, Ringer’s injection, lactated, or solutions containing any combination of dextrose and sodium chloride with concentrations not exceeding 2.5 and 0.45%, respectively;³⁰⁰⁴; ³⁰⁰⁵ the vial contents should be mixed gently to ensure complete dissolution.³⁰⁰⁴ Each mL of the resultant reconstituted solution contains approximately 167 mg of ceftazidime plus 42 mg of avibactam.³⁰⁰⁴ The reconstituted solution is not suitable for direct injection and must be diluted prior to infusion.³⁰⁰⁴

For adult and pediatric patients weighing 40 kg or more, the manufacturer’s instructions for preparing various dosages of ceftazidime-avibactam with final ceftazidime and avibactam concentrations of 8 to 40 and 2 to 10 mg/mL, respectively, from the reconstituted solution are as follows:³⁰⁰⁴

For 2.5 g (ceftazidime 2 g plus avibactam 0.5 g), withdraw the entire vial contents (i.e., 12 mL) and add to an infusion bag to achieve a total volume of 50 to 250 mL in a compatible diluent.

For 1.25 g (ceftazidime 1 g plus avibactam 0.25 g), withdraw 6 mL and add to an infusion bag to achieve a total volume of at least 50 mL (but less than 250 mL) in a compatible diluent.

For 940 mg (ceftazidime 750 mg plus avibactam 190 mg), withdraw 4.5 mL and add to an infusion bag to achieve a total volume of at least 50 mL (but less than 250 mL) in a compatible diluent.

For pediatric patients weighing less than 40 kg, the appropriate volume of the reconstituted solution to achieve the prescribed dose should be withdrawn from the vial and diluted in a compatible diluent to final ceftazidime and avibactam concentrations of 8 to 40 and 2 to 10 mg/mL, respectively.³⁰⁰⁴

The same diluent should be used for both reconstitution and further dilution unless the drug was reconstituted with sterile water, in which case any compatible diluent should be used for further dilution.³⁰⁰⁴ The diluted solution for infusion should be mixed gently to ensure complete dissolution and visually inspected for particulate matter and discoloration.³⁰⁰⁴

Sodium Content

Each 2.5-g vial contains approximately 6.4 mEq (146 mg) of sodium.³⁰⁰⁴

Trade Name(s)

Avycaz

Ceftazidime-avibactam sodium is administered by intravenous infusion over 2 hours following dilution of the reconstituted solution in a suitable infusion solution.³⁰⁰⁴

Intact vials should be stored at controlled room temperature and protected from light by storing in the original carton.³⁰⁰⁴ Ceftazidime-avibactam sodium is a white to yellow powder that ultimately forms a clear to light yellow solution upon reconstitution and subsequent dilution.³⁰⁰⁴ After reconstitution with an appropriate diluent as instructed, the drug may be stored for no longer than 30 minutes prior to dilution.³⁰⁰⁴ Following dilution, the drug should be used within 12 hours when stored at room temperature; alternatively, the diluted solution may be stored up to 24 hours at 2 to 8°C and then should be used within 12 hours of subsequent storage at room temperature.³⁰⁰⁴

Solution Compatibility

Y-Site Injection Compatibility (1:1 Mixture)

For a list of references cited in the text of this monograph, search the monograph titled References.

ASHP^® Injectable Drug Information^TM. Selected Revisions March 31, 2024. © Copyright, 2024. American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.