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[Pharmacology](https://durgical.com/en/pharmacology/) · [Beta-lactams](https://durgical.com/en/pharmacology/classes/beta-lactams/)

# Ceftazidime + avibactam

Ceftazidime protected by avibactam, a non-β-lactam inhibitor active against KPC and OXA-48; reserved for resistant gram-negatives.

Updated 2026-11-01

- Class: [Beta-lactams](https://durgical.com/en/pharmacology/classes/beta-lactams/)
- Enzyme: Bacterial PBPs (ceftazidime) and class A, C and some class D β-lactamases (avibactam)
- ATC code: J01DD52
- WHO Model List of Essential Medicines

Also called: ceftazidime–avibactam

✂**Bacterial PBPs (ceftazidime) and class A, C and some class D β-lactamases (avibactam)**Ceftazidime + avibactam

ⓘ The figure shows avibactam covalently bound to the KPC-2 carbapenemase of Klebsiella pneumoniae.

**Target in 3D:** Bacterial PBPs (ceftazidime) and class A, C and some class D β-lactamases (avibactam). PDB structure 4ZBE (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4ZBE) · Drag to rotate · pinch to zoom

## Mechanism of action

Ceftazidime acylates the PBPs of gram-negatives, including Pseudomonas aeruginosa. Avibactam is a non-β-lactam β-lactamase inhibitor, active against Ambler class A enzymes, including KPC carbapenemases, class C (AmpC) and some class D enzymes such as OXA-48. It does not inhibit metallo-β-lactamases (class B, such as NDM), so it fails against those strains.

- Avibactam binds the serine of KPC, AmpC or OXA-48
- The β-lactamase is inhibited and cannot destroy ceftazidime
- Ceftazidime acylates the gram-negative PBP3
- The bacterium cannot build its septum and lyses

## Pharmacokinetics

**Absorption**
Intravenous only.

**Elimination**
Both components by the kidney; adjusted in kidney failure.

## Indications

- Complicated intra-abdominal infections, with metronidazole. [Peritonitis →](https://durgical.com/en/conditions/peritonitis/)
- Complicated urinary tract infections, including pyelonephritis. [Acute pyelonephritis →](https://durgical.com/en/conditions/acute-pyelonephritis/)
- Hospital-acquired and ventilator-associated pneumonia.

## Adverse effects

### Common

- Nausea, vomiting, diarrhoea, constipation
- Abdominal pain, dizziness, headache

### Serious (rare, important)

- Anaphylaxis
- Clostridioides difficile diarrhoea, from mild to severe colitis

## Contraindications

- Serious hypersensitivity to any component or to other β-lactams

## Key interactions

**Probenecid**
Reduces tubular secretion: higher and longer-lasting β-lactam levels.

## What is monitored

- Creatinine (dose adjustment)
- Cultures and carbapenemase type (KPC, OXA-48 or metallo-β-lactamase)

## Administration and safety

- Intravenous infusion only.
- Do not confuse with plain ceftazidime: the spectrum differs.
- It is reserved for resistant gram-negative infections under the antimicrobial stewardship programme.

## Nursing care

- Before the first dose: ask about allergy to penicillins, cephalosporins and other β-lactams, and what the reaction was.
- Monitor creatinine and urine output.
- Teach the patient to report watery or bloody diarrhoea, even weeks after the course ends.

## Pregnancy and breastfeeding

Data in pregnant women are limited; it is used only if the benefit justifies the risk, and the team is told about any pregnancy.

## Memory aid

'AVIbactam = rescue plane against KPC': it lands where ceftazidime alone cannot, but not on metallo-β-lactamases (NDM).

## Test yourself

Think of the answer, then tap the question to see it.

## Which β-lactamases does avibactam inhibit, and which not?

It inhibits class A (including KPC), class C (AmpC) and some class D such as OXA-48; it does not inhibit metallo-β-lactamases (class B).

## What chemically sets avibactam apart from clavulanic acid or tazobactam?

It is not a β-lactam, whereas the traditional inhibitors resemble β-lactams; it also covers β-lactamase classes they do not inhibit.

## Which drug is it combined with in intra-abdominal infections, and why?

With metronidazole, to cover anaerobes.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/ceftazidime-avibactam/)

## Related drugs

- [Ceftazidime](https://durgical.com/en/pharmacology/ceftazidime/)
- [Ceftolozane + tazobactam](https://durgical.com/en/pharmacology/ceftolozane-tazobactam/)
- [Cefiderocol](https://durgical.com/en/pharmacology/cefiderocol/)
- [Piperacillin + tazobactam](https://durgical.com/en/pharmacology/piperacillin-tazobactam/)

## Related conditions

- [Peritonitis](https://durgical.com/en/conditions/peritonitis/)
- [Acute pyelonephritis](https://durgical.com/en/conditions/acute-pyelonephritis/)

[← Back to the class: Beta-lactams](https://durgical.com/en/pharmacology/classes/beta-lactams/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Ceftazidime and Avibactam Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a615018.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [RCSB PDB - 4ZBE: Crystal structure of KPC-2 beta-lactamase complexed with avibactam](https://www.rcsb.org/structure/4ZBE) (RCSB Protein Data Bank, 2026); Farmacología básica y clínica (Katzung), cap. 43 (McGraw Hill, 2025).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/ceftazidime-avibactam/