Zavicefta (ceftazidime/avibactam) / Pfizer, AbbVie - LARVOL DELTA

Assessment of in vitro antimicrobial activities of ceftolozane/tazobactam and ceftazidime/avibactam against carbapenem-resistant Pseudomonas aeruginosa clinical isolates. (PubMed, BMC Infect Dis) - "Modified carbapenem inactivation method test gave satisfactory results and could be used as an alternative to expensive genotypic methods. Ceftazidim/avibactam and ceftolozane/tazobactam were unsuccessful against carbapenem resistant P. aeruginosa isolates carrying carbapenemase genes especially metallo-β lactamase genes. Therefore, it is essential to detect susceptibility patterns to newly introduced β-Lactam/β-Lactamase inhibitor combinations due to the emerging resistance to these therapeutics."

Journal • Preclinical

Association Between Antimicrobials and Pump Proton Inhibitors Consumption with the Incidence of Nosocomial Clostridiodes difficile Infection in High Complexity Hospitals in Costa Rica. (PubMed, Antibiotics (Basel)) - " A downward trend for cephalexin, ceftriaxone, clindamycin, gentamicin, macrolides, metronidazole, and penicillin sodium was identified. In contrast, an upward trend was recognized for amoxicillin, ceftazidime/avibactam, ertapenem, fluconazole, ketoconazole, levofloxacin, and tigecycline...Specific events, such as the COVID-19 pandemic and the implementation of ASP, have had no correlation with CDI. Further analysis is required in Latin America to advance our understanding of risk factors associated with CDI."

Journal • Infectious Disease • Novel Coronavirus Disease

Emergence of KPC-8-producing K. pneumoniae infection without prior exposure to ceftazidime/avibactam: the threat of de novo infections by ceftazidime/avibactam-resistant KPC variants. (PubMed, Antimicrob Agents Chemother) - "During a 15-month follow-up, changes in carbapenem susceptibility due to porin alterations were observed, remaining susceptible to meropenem/vaborbactam, imipenem/relebactam, and cefiderocol. High- and low-permeability recombinant Escherichia coli isolates analysis revealed that, unlike the widespread ceftazidime/avibactam-resistant variant KPC-31, KPC-8 confers ceftazidime/avibactam resistance without decreasing carbapenemase activity."

Journal • Infectious Disease • Pneumonia

Azithromycin represses evolution of ceftazidime/avibactam resistance by translational repression of rpoS in Pseudomonas aeruginosa. (PubMed, J Bacteriol) - "Moreover, we found that azithromycin represses the translation initiation of rpoS through its 5´-terminal rare and less frequent codons, thereby subsequently reducing the mutational frequency of CZA resistance. Therefore, our work provides a promising antibiotic combination for the treatment of P. aeruginosa infections."

Journal • Infectious Disease

Characterization of Enterobacter cloacae and Citrobacter freundii Species Complex Isolates with Decreased Susceptibility to Cephalosporins from United States Hospitals and Activity of Aztreonam-Avibactam and Comparator Agents (2019-2023). (PubMed, Antibiotics (Basel)) - "Aztreonam-avibactam was highly active against cephalosporin-nonsusceptible ECLC and CFC, including MBL producers. The activities of ceftazidime-avibactam, meropenem-vaborbactam, and cefiderocol were compromised against CB-R isolates due to the high frequency of NDM producers."

Journal • Infectious Disease

Investigation of the In Vitro Synergistic Effect of CeftazidimeAvibactam, Fosfomycin and Meropenem in CarbapenemResistant Klebsiella pneumoniae Isolates (PubMed, Mikrobiyol Bul) - "KDKp izolatlarının tedavisinde sıklıkla tercih edilen bir antibiyotik olan CZA metallo-beta-laktamaz üreten izolatlarda etkili olmamaktadır. Bu çalışma sonucunda, seftazidim-avibaktamın FOS ile kombinasyonundan ziyade MEM ile kombinasyonunun ciddi KDKp enfeksiyonlarında bir tedavi seçeneği olarak önerilebileceği kanaati oluşmuştur."

Journal • Preclinical • Infectious Disease • Pneumonia

Pharmacokinetic/Pharmacodynamic Analysis of Extended/Two-Step Infusion Ceftazidime/Avibactam in Children With Gram-Negative Bacterial Infections. (PubMed, Clin Ther) - "The current STD of CZA may not adequately meet the therapeutic requirements in children, thus it is recommended to optimize the dosing regimen by extended/two-step infusion or increasing the daily dose, guided by therapeutic drug monitoring."

Journal • PK/PD data • Infectious Disease

High-level ceftazidime-avibactam resistance by in-host evolution of blaKPC genes: emergence of a novel blaKPC-102 variant and increase of blaKPC-33 copy number in Klebsiella pneumoniae strains from a lung transplantation recipient. (PubMed, Int J Antimicrob Agents) - "Enzymatic kinetic analysis revealed that KPC-2 demonstrated the highest catalytic efficiency to nitrocefin and meropenem, whereas KPC-33 displayed higher catalytic efficiency against ceftazidime compared to other tested KPC variants. The CZA resistance resulting from blaKPC mutation could be selected and evolved to be more diverse and heterogeneous within the host after CZA therapy. It is essential to perform the surveillance of CZA-resistance for clinicians during treatment."

Journal • Infectious Disease • Pneumonia • Transplantation

Targeted 'knock out' therapy with a combination antimicrobial regimen restores treatment options in the management of extensively drug-resistant carbapenemase-producing organisms. (PubMed, J Med Microbiol) - "Cefiderocol (FDC) and the combination of ceftazidime-avibactam and aztreonam (CZA+ATM) are emerging therapeutic options to combat carbapenemase-producing organisms (CPOs) that exhibit resistance due to multiple β-lactamases.Hypothesis/Gap Statement...To evaluate the in vitro efficacy of FDC and CZA+ATM against CPOs and to compare colistin (CST) MICs obtained locally with those from the reference laboratory.Methodology...The VITEK2 may provide presumptive categorical information for CST susceptibility, but MICs must be confirmed by broth microdilution as VMEs can lead to treatment failures. Moreover, our study confirms potent in vitro activity of CZA+ATM against CPOs expressing multiple β-lactamases."

Journal • Infectious Disease

Gut colonization guided versus routine empiric antimicrobial therapy to manage infections in patients with cirrhosis: a pragmatic randomized trial (EASL 2025) - "Of 43 carbapenemase-positive patients, 40 in the intervention group received ceftazidime-avibactam plus aztreonam or polymyxin-based therapy. This is the first randomized trial to show that Xpert Carba-R and rectal colonization- guided antimicrobials improve survival, infection resolution, and organ function in cirrhosis patients with infections. These findings support integrating gut colonization assessments into the routine care of cirrhosis patients."

Clinical • Fibrosis • Hepatology • Immunology • Infectious Disease • Oncology • Pneumonia • Respiratory Diseases

Pharmacokinetics and Safety of Ceftazidime-Avibactam in Neonates and Young Infants: a Phase 2a, Multicenter Prospective Trial. (PubMed, J Pediatric Infect Dis Soc) - "Plasma exposures after single and multiple CAZ/AVI doses in neonates and young infants 28 days; 25 [20/5] mg/kg/dose for ≤28 days) were similar to approved doses for older children. The safety profile of CAZ/AVI was as expected based on previous observations."

Journal • P2a data • PK/PD data • Infectious Disease • Nephrology • Septic Shock

Characterization of the genome of a Klebsiella pneumoniae clinical strain carrying a novel KPC-205 variant associated with resistance to ceftazidime/avibactam and cefiderocol. (PubMed, Int J Antimicrob Agents) - No abstract available

Journal • Infectious Disease • Pneumonia

An Assessment Of Cefiderocol's Synergistic Effects With Eravacycline, Colistin, Meropenem, Levofloxacin, Ceftazidime/avibactam, And Tobramycin Against Carbapenem-Resistant and -Susceptible Pseudomonas aeruginosa. (PubMed, Microb Pathog) - "The findings of this study indicate that combining cefiderocol enhances its synergistic efficacy against both carbapenem-resistant and susceptible P. aeruginosa strains. This suggests that combination therapy could serve as a potential alternative for treating resistant P. aeruginosa infections."

Journal • Critical care • Infectious Disease

Prevalence of New Delhi Metallo-β-lactamase (blaNDM) gene in a selected population of drug-resistant clinical isolates. (PubMed, Mol Biol Rep) - "The high prevalence of blaNDM in our study has of great concern for clinical practice and public health. Clinicians are left with few therapeutic options. However, ceftazidime/avibactam with aztreonam may show therapeutic success. Continuous surveillance is crucial to monitorgenetic variations of continuously evolving blaNDM gene, which is essential for effective clinical management."

Journal • Infectious Disease

Evolving antimicrobial resistance of extensively drug-resistant Gram-negative severe infections associated with conflict wounds in Ukraine: an observational study. (PubMed, Lancet Reg Health Eur) - "Gentamicin (p = 0.0046) and colistin (p = 0.049) resistance were higher in infections arising later. Overall, resistance rates for amikacin (74/100, 74.0%), cefiderocol (44/100, 44.0%) and ceftazidime-avibactam (26/79, 67.1%) were observed...A diverse presence of carbapenemase genes amid XDR Gram negative phenotypes highlights the importance of early screening for mechanisms of resistance in this setting. This study was funded by the Healthcare Infection Society and CW+ Charity."

Journal • Observational data • Infectious Disease • Pneumonia

Clinical and Microbiological characteristics of patients with ceftazidime/avibactam-resistant Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae strains. (PubMed, Ann Clin Microbiol Antimicrob) - "CZA-resistant KPC-producing K. pneumoniae is associated with high mortality. Strains producing KPC variants are more likely to exhibit restored meropenem susceptibility and higher levels of CZA resistance."

Journal • Infectious Disease • Pneumonia

Emergence and characterization of IncFII/IncR plasmids with multiple 5,692 bp- bla KPC-2-bearing tandem repeats in ceftazidime/avibactam non-susceptible Klebsiella pneumoniae strains. (PubMed, Front Microbiol) - "Compared with KP1880, the β-lactamase hydrolysis activities of crude cell lysates derived from KP1878 and KP3034 were significantly higher in their ability to hydrolyze meropenem, ceftazidime, and nitrocefin. S1-nuclease-digested pulsed-field gel electrophoresis, along with Southern blot and restriction fragment length polymorphism fingerprinting, identified plasmid profiles but revealed one or more 5.6-kilobase variations in the regions hybridized with the KPC-specific probe. Further comparative genomic analysis suggested that a potential homologous recombination event occurred between the bla KPC-2-carrying plasmid and the pLVPK-like virulence plasmid of KP3034, leading to the generation of a cointegrated plasmid that combined both virulence and CAZ/AVI resistance."

Journal • Infectious Disease • Pneumonia

Cerebrospinal fluid concentrations of ceftaroline and ceftazidime/avibactam in healthy volunteers: pharmacokinetics and probability of target attainment. (PubMed, Int J Antimicrob Agents) - "In healthy subjects, ceftaroline, ceftazidime and avibactam poorly distribute to CSF. Nonetheless, CSF exposure of both cephalosporins might be sufficient to cover certain, but not all, pathogens causative of CNS infections."

Journal • PK/PD data • Infectious Disease

Daratumumab Desensitization in a Heart Transplant Candidate with Chronic Driveline Infection (ISHLT 2025) - "We describe use of daratumumab desensitization in a BTT heart transplant (HT) candidate with a chronic MDRO driveline infection (DLI) intolerant of conventional desensitization therapies.Case Report The patient was status post LVAD implantation two years prior for NICM, complicated by several gastrointestinal bleeds, a chronic hematoma at the outflow graft impeding LVAD function, and chronic MDRO pseudomonas DLI requiring debridement and chronic suppression with ceftazidime/avibactam...Desensitization was initiated with plasmapheresis (6 sessions), IVIg (2 g/kg) and rituximab (375 mg/m2) with an appropriate decline in her PRAs...Daratumumab-hyaluronidase (dara-hyal) was initiated (starting at 2mg/kg and increasing by 2mg/kg each dose) and IVIg (1g/kg) alternating every other week for four doses each...She was induced with basiliximab and maintained on tacrolimus (goal 12-15 mcg/mL), mycophenolate and methylprednisolone. By 90 days post-HT, she has had no rejection based..."

Cardiovascular • Gastrointestinal Disorder • Heart Failure • Hematological Disorders • Infectious Disease • Transplantation

The ongoing antibiotic resistance and carbapenemase encoding genotypes surveillance. The first quarter report of the INVIFAR network for 2024. (PubMed, PLoS One) - "aeruginosa had higher resistance to ceftazidime-avibactam, ceftolozane-tazobactam, cefepime, and imipenem (p < 0.05) in the 18-59 years group...coli had the highest resistance to carbapenems (p < 0.01), and P. aeruginosa for ceftazidime (p = 0.005), cefepime (p = 0.003), piperacillin-tazobactam (p = <0.01), IPM (p = 0.006), and meropenem (p = <0.01) in clinical isolates recovered from patients in the intensive care unit (ICU). For K. pneumoniae, the highest resistance to ertapenem was observed in clinical isolates from the ICU area (p < 0.035)...A high multidrug resistance was observed for A. baumannii and E. coli strains. A high susceptibility to caspofungin and voriconazole was observed for Candida albicans collected from blood."

Journal • Critical care • Infectious Disease • Pneumonia

Diagnostic algorithm for the detection of carbapenemases and extended-spectrum β-lactamases in carbapenem-resistant Pseudomonas aeruginosa. (PubMed, Microbiol Spectr) - "We used the following BL-BLI combinations: ceftolozane-tazobactam (C-T), ceftazidime-avibactam, imipenem-relebactam (I-R), meropenem-vaborbactam, cefepime-enmetazobactam (C-E), and aztreonam-avibactam. This method is particularly valuable for laboratories lacking access to molecular diagnostics, as it provides a practical alternative for routine testing. By facilitating the early detection of resistant P. aeruginosa strains, this approach has the potential to improve patient outcomes, optimize antimicrobial therapy, and enhance global surveillance efforts against multidrug-resistant pathogens."

Journal • Infectious Disease

A Study to Learn About the Study Medicine - Zavicefta in Patients With Sepsis or Loss of Kidney Function in Japan (clinicaltrials.gov) - P=N/A | N=59 | Not yet recruiting | Sponsor: Pfizer | Initiation date: Mar 2025 ➔ Sep 2025

Trial initiation date • Infectious Disease • Renal Disease • Septic Shock

The efficacy and safety of ceftazidime/avibactam or polymyxin B based regimens for carbapenem-resistant Pseudomonas aeruginosa infection: a multicenter real-world and propensity score-matched study. (PubMed, Front Pharmacol) - "In conclusion, CAZ/AVI-based regimens demonstrated superior efficacy in clearing CRPA compared to PMB-based regimens. Furthermore, several factors associated with AKI and mortality in CRPA-infected patients were identified, highlighting the need for further research to optimize treatment strategies."

Journal • Real-world evidence • Acute Kidney Injury • Diabetes • Infectious Disease • Metabolic Disorders • Renal Disease • Septic Shock

Isolation and Characterization of a Novel Lytic Phage N22 and Its Effect on Drug-Resistant Klebsiella Pneumoniae. (PubMed, Infect Drug Resist) - "This study aimed to address the multidrug resistance crisis in intensive care units by exploring the use of ceftazidime/avibactam (CAZ/AVI), a widely used clinical antimicrobial agent, in conjunction with phage therapy...This study provides a preliminary investigation into the effects of combining CAZ/AVI with phage therapy, highlighting its potential significance in developing novel therapeutic strategies for bacterial infections resistant to CAZ/AVI. The findings underscore the importance of advancing highly effective phage agents as alternative treatment modalities for patients with infections refractory to conventional antibiotics."

Journal • Critical care • Infectious Disease • Pneumonia

CEFTAZIDIME-AVIBACTAM PLUS AZTREONAM IN MANAGING MULTIDRUG-RESISTANT GRAM-NEGATIVE INFECTIONS IN PAEDIATRICS: A SINGLE-CENTRE CASE SERIES. (ESPID 2025) - "Background Aztreonam-avibactam targets multidrug-resistant (MDR) Gram-negative pathogens, including those producing metallo-β-lactamases (MBL). Combination of aztreonam-avibactam has recently been licensed to use in adults and may soon be available in children. Larger trials are needed to establish its efficacy and place in paediatric guidelines."

Clinical • Gram negative • Cognitive Disorders • Infectious Disease • Pediatrics