Zavicefta® (Ceftazidime-Avibactam) — Novel Beta-Lactam/Beta-Lactamase Inhibitor for Drug-Resistant Gram-Negative Infections

First Approved Beta-Lactamase Inhibitor Active Against KPC and OXA-48 Carbapenemases

Zavicefta® (Ceftazidime-Avibactam) is a combination antibiotic consisting of Ceftazidime — a third-generation cephalosporin — and Avibactam — a novel non-beta-lactam beta-lactamase inhibitor. Zavicefta is used to treat serious gram-negative infections caused by carbapenem-resistant organisms including carbapenem-resistant Enterobacteriaceae (CRE) with KPC and OXA-48 carbapenemases, and carbapenem-resistant Pseudomonas aeruginosa.

A.K. Pharma is a trusted medicine distributor in Delhi supplying genuine Zavicefta (Ceftazidime-Avibactam) to hospitals, ICUs, infectious disease units, and pharmacies across India. Manufactured by Pfizer, Zavicefta is one of the most important last-resort antibiotics available for multidrug-resistant gram-negative infections — a growing crisis in Indian hospitals.

What is Zavicefta (Ceftazidime-Avibactam)?

Zavicefta combines two active components:

Ceftazidime — a third-generation cephalosporin that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs). Ceftazidime has broad activity against gram-negative bacteria but is susceptible to inactivation by beta-lactamase enzymes — particularly ESBLs, AmpC, and carbapenemases.

Avibactam — a novel diazabicyclooctane (DBO) beta-lactamase inhibitor that protects Ceftazidime from degradation by a broad range of beta-lactamases including:

• Class A serine carbapenemases — KPC (Klebsiella pneumoniae carbapenemase)
• Class D serine carbapenemases — OXA-48 and related enzymes
• Class C beta-lactamases — AmpC
• Class A ESBLs — TEM, SHV, CTX-M

Avibactam does NOT inhibit Class B metallo-beta-lactamases (NDM, VIM, IMP) — this is an important limitation distinguishing Zavicefta from Fetroja (Cefiderocol).

Full prescribing information is available at the FDA label for Ceftazidime-Avibactam.

Clinical Studies and Evidence

RECLAIM Trial (Ceftazidime-Avibactam for cIAI) Published in The Lancet Infectious Diseases (2016), the RECLAIM trial demonstrated Ceftazidime-Avibactam was non-inferior to Meropenem for complicated intra-abdominal infections — with clinical cure rates of 81.6% vs 85.1%.

REPRISE Trial (Ceftazidime-Avibactam for CRE and Pseudomonas) Published in Clinical Infectious Diseases (2016), the REPRISE trial demonstrated Ceftazidime-Avibactam achieved superior outcomes compared to best available therapy in patients with CRE and carbapenem-resistant Pseudomonas infections — with clinical cure rates of 69% vs 56% for BAT.

ATTACK Trial (Ceftazidime-Avibactam for Nosocomial Pneumonia) Published in The Lancet Infectious Diseases (2018), the ATTACK trial demonstrated Ceftazidime-Avibactam was non-inferior to Meropenem for hospital-acquired and ventilator-associated pneumonia — with 28-day all-cause mortality of 9.5% vs 10.2%.

Real-World CRE Studies Multiple real-world studies from Italy, Spain, Greece, and India demonstrate Ceftazidime-Avibactam’s superiority over Colistin-based regimens for KPC-producing CRE infections — with significantly lower mortality and better tolerability.

India-Specific Data Real-world studies from Indian tertiary care hospitals demonstrate high rates of KPC and OXA-48 producing CRE in ICU settings — and Zavicefta’s critical role as a carbapenem-sparing and Colistin-sparing treatment option.

Available Strengths

Zavicefta is available as:

• 2g Ceftazidime / 0.5g Avibactam powder for concentrate for solution for infusion (vial)

The recommended dose is 2.5g (2g Ceftazidime + 0.5g Avibactam) IV every 8 hours — administered as a 2-hour extended infusion. Dose reduction is required in renal impairment.

Indications — What Zavicefta is Used For

Complicated Intra-Abdominal Infections (cIAI)

• In combination with Metronidazole for complicated intra-abdominal infections caused by susceptible gram-negative bacteria

Hospital-Acquired Pneumonia / Ventilator-Associated Pneumonia (HAP/VAP)

• Treatment of HAP/VAP caused by susceptible gram-negative bacteria including carbapenem-resistant Pseudomonas aeruginosa and CRE

Complicated Urinary Tract Infections (cUTI)

• Including pyelonephritis caused by susceptible gram-negative bacteria

Carbapenem-Resistant Gram-Negative Infections

• Treatment of infections caused by KPC-producing CRE (Klebsiella pneumoniae, E. coli, Enterobacter)
• Treatment of OXA-48-producing CRE infections
• Treatment of carbapenem-resistant Pseudomonas aeruginosa infections

For detailed indication information refer to NCI Ceftazidime-Avibactam Drug Information and MedlinePlus Ceftazidime-Avibactam.

Key Benefits of Zavicefta

First Agent Active Against KPC-Producing CRE Zavicefta was the first approved antibiotic with proven activity against KPC-producing carbapenem-resistant Enterobacteriaceae — the most common carbapenemase mechanism globally and in India — filling a critical therapeutic gap.

Colistin-Sparing Treatment Zavicefta enables treatment of CRE infections without Colistin — avoiding Colistin’s significant nephrotoxicity and neurotoxicity while achieving superior clinical outcomes in KPC-CRE infections.

Superior to Best Available Therapy in CRE The REPRISE trial demonstrated superior clinical outcomes with Zavicefta compared to best available therapy (typically Colistin-based combinations) in CRE infections — a landmark result establishing it as the preferred treatment for KPC-CRE.

Active Against OXA-48 Producing Organisms Avibactam’s inhibition of OXA-48 carbapenemase — increasingly common in Indian and Middle Eastern hospitals — extends Zavicefta’s coverage beyond KPC to this important resistance mechanism.

Well Tolerated Zavicefta has a significantly better tolerability profile than Colistin — the previous standard of care for CRE — with substantially lower rates of nephrotoxicity.

Resistance Potential Monitoring Avibactam’s covalent but reversible binding to beta-lactamases means resistance can emerge during treatment — susceptibility testing and clinical monitoring are essential.

How Zavicefta Works

Ceftazidime Component:

• Penetrates the outer membrane of gram-negative bacteria through porins
• Binds to penicillin-binding proteins (PBPs) — particularly PBP1b, PBP1c, and PBP3 in Pseudomonas
• Inhibits transpeptidase activity — blocking peptidoglycan cross-linking
• Disrupts cell wall synthesis — leading to bacterial cell lysis and death

Avibactam Component:

• Penetrates the outer membrane and reaches the periplasm
• Covalently and reversibly acylates the active site serine of beta-lactamase enzymes
• Inhibits Class A (KPC, ESBL), Class C (AmpC), and Class D (OXA-48) beta-lactamases
• Protects Ceftazidime from enzymatic degradation — restoring its antibacterial activity
• Avibactam’s reversible binding distinguishes it from classical beta-lactamase inhibitors and may contribute to lower resistance selection pressure

Important Limitation: Avibactam does NOT inhibit Class B metallo-beta-lactamases (MBLs) — NDM, VIM, IMP. For NDM-producing CRE infections Fetroja (Cefiderocol) should be considered instead.

For a detailed mechanism overview refer to the IDSA Antimicrobial Resistance Guidance.

Zavicefta vs Fetroja — Choosing the Right Last-Resort Antibiotic

Key decision point: If the resistance mechanism is KPC or OXA-48 — use Zavicefta. If NDM or CRAB — use Fetroja. If unknown — test susceptibility or use both based on clinical severity.

Dosage and Administration

Standard Dose (CrCl ≥51 mL/min):

• 2.5g (Ceftazidime 2g + Avibactam 0.5g) IV every 8 hours
• Administered as 2-hour extended infusion
• Total daily dose: 7.5g

Renal Impairment Dose Adjustments:

• CrCl 31-50 mL/min: 1.25g every 8 hours
• CrCl 16-30 mL/min: 0.94g every 12 hours
• CrCl 6-15 mL/min: 0.94g every 24 hours
• CrCl ≤5 mL/min or haemodialysis: 0.94g every 48 hours

Duration:

• cUTI: 7-14 days
• cIAI: 5-14 days
• HAP/VAP: 7-14 days
• CRE infections: as clinically indicated — typically 14-21 days

Administration:

• Reconstitute with sterile water or normal saline
• Further dilute in normal saline, 5% glucose, or Ringer’s lactate
• Administer as 2-hour IV infusion
• Compatible with Metronidazole for cIAI combination therapy

Full dosing guidelines available at Drugs.com Ceftazidime-Avibactam Dosage.

Who Should Use Zavicefta

Zavicefta is prescribed for:

• ICU patients with KPC or OXA-48 producing CRE infections
• Patients with carbapenem-resistant Pseudomonas aeruginosa infections
• Patients with HAP/VAP caused by resistant gram-negative pathogens
• Patients with CRE infections where Colistin is being avoided due to toxicity
• Patients with complicated UTI or cIAI caused by ESBL or carbapenem-resistant pathogens

Zavicefta is prescribed by infectious disease specialists, intensivists, and clinical microbiologists. A.K. Pharma supplies Zavicefta to hospitals, ICUs, and infectious disease units across Delhi and India.

Possible Side Effects

Common side effects include diarrhoea, nausea, vomiting, elevated liver enzymes, and injection site reactions.

Serious side effects include:

• Clostridioides difficile associated diarrhoea — monitor during and after treatment
• Severe hypersensitivity reactions — particularly in patients with beta-lactam allergy
• Neurological effects — encephalopathy, seizures, particularly in renal impairment with inadequate dose adjustment
• Elevated transaminases — monitor liver function during prolonged therapy

Full side effect information available at FDA Ceftazidime-Avibactam Safety Information.

Precautions

• Susceptibility testing essential before initiating — not all resistant isolates are susceptible
• Dose adjustment mandatory in renal impairment — inadequate dose adjustment increases neurotoxicity risk
• Monitor renal function regularly during therapy
• Cross-reactivity with penicillins possible — use with caution in penicillin-allergic patients
• Monitor for resistance emergence during prolonged treatment — repeat susceptibility testing if clinical deterioration
• Consult infectious disease specialist for complex carbapenem-resistant infections
• Consider combination therapy for severe infections — Zavicefta + Aztreonam for MBL-producing organisms

Storage and Handling

• Store unreconstituted vials at room temperature below 25°C
• After reconstitution and dilution — use within specified timeframes based on diluent and storage temperature
• Protect from light
• Single use vials — discard unused portion

As a responsible medicine distributor in Delhi, A.K. Pharma stores all medicines including Zavicefta under manufacturer-recommended conditions ensuring product integrity for every supply to hospitals and ICUs.

Manufacturer Information

Zavicefta (Ceftazidime-Avibactam) is manufactured by Pfizer Inc., a global pharmaceutical leader. Ceftazidime-Avibactam received FDA approval in February 2015 for cUTI and cIAI, with subsequent approval for HAP/VAP. A.K. Pharma supplies only genuine Zavicefta sourced from authorized Pfizer distributors.

Related Antibiotic Medicines Available at A.K. Pharma

• Fetroja (Cefiderocol) — siderophore cephalosporin active against NDM-producing CRE and CRAB
• Ambisome (Amphotericin B) — liposomal antifungal for severe fungal infections
• Candipoz (Posaconazole) — broad spectrum oral antifungal
• Browse all Anti Biotic Medicines available at A.K. Pharma

Frequently Asked Questions

Q. What is Zavicefta used for? Zavicefta (Ceftazidime-Avibactam) is used to treat serious gram-negative infections including carbapenem-resistant infections caused by KPC and OXA-48 producing organisms, complicated UTI, complicated intra-abdominal infections, and hospital-acquired pneumonia. More information available at MedlinePlus.

Q. What is the generic name of Zavicefta? The generic name of Zavicefta is Ceftazidime-Avibactam. It is a combination of a third-generation cephalosporin (Ceftazidime) and a novel beta-lactamase inhibitor (Avibactam).

Q. Is Zavicefta active against NDM-producing bacteria? No. Avibactam does not inhibit Class B metallo-beta-lactamases including NDM — the most common carbapenemase in India. For NDM-producing CRE infections Fetroja (Cefiderocol) should be used instead.

Q. How is Zavicefta different from Fetroja? Zavicefta is the preferred choice for KPC and OXA-48 producing CRE and carbapenem-resistant Pseudomonas. Fetroja covers a broader spectrum including NDM-producing CRE and CRAB. Susceptibility testing guides the choice between the two.

Q. Is Zavicefta available in India? Zavicefta can be supplied to hospitals, ICUs, and infectious disease units across India through licensed pharmaceutical distributors. Contact A.K. Pharma — medicine distributor in Delhi — for availability and pricing.

Q. What is the price of Zavicefta in India? Zavicefta price in India varies by pack size. Contact A.K. Pharma at 011 4172 6999 or WhatsApp +91 9810034827 for current pricing and bulk supply rates.

Q. How to order Zavicefta from A.K. Pharma? You can request a quote directly from this page, call us at 011 4172 6999, or WhatsApp us at +91 9810034827 with your requirements and we will respond promptly.

Q. Does A.K. Pharma supply Zavicefta in bulk? Yes. A.K. Pharma supplies Zavicefta in bulk to hospitals, ICUs, and infectious disease units across Delhi and India. Contact us for bulk pricing and availability.

Why Order Zavicefta from A.K. Pharma?

• Licensed medicine distributor in Delhi with all required drug licenses
• 100% genuine Zavicefta sourced from authorized Pfizer distributors
• Reliable supply to hospitals and ICUs across India
• Bulk supply available with competitive pricing
• Prompt response to all quote requests
• Serving infectious disease specialists and intensivists across Delhi NCR and India

Contact A.K. Pharma for Zavicefta Supply 📍 E-2/257A, 2nd Floor, Shastri Nagar, New Delhi 110052 📞 011 4172 6999 📱 WhatsApp: +91 9810034827 🌐 akpharma.in