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Information on how to access prescribing information and adverse event reporting can be found at the bottom of the page.

ZAVICEFTA® (ceftazidime-avibactam): A safety and tolerability profile consistent with both cephalosporins and carbapenems1-4

Adverse Events

Special Warnings and Precautions for Use

Drug-drug interactions

Low potential for drug-drug interactions5

In vitro drug combination studies with ZAVICEFTA have demonstrated neither synergy nor antagonism with the following drugs: metronidazole, tobramycin, levofloxacin, vancomycin, linezolid, colistin and tigecycline. 

Interaction with other antimicrobial agents: 

Concurrent treatment with high doses of cephalosporins and nephrotoxic medicinal products such as aminoglycosides or potent diuretics (e.g. furosemide) may adversely affect renal function. Chloramphenicol is antagonistic in vitro with ceftazidime and other cephalosporins. The clinical relevance of this finding is unknown, but due to the possibility of antagonism in vivo this drug combination should be avoided.

Interaction with other medicinal products and other forms of interaction: 

In vitro, avibactam is a substrate of OAT1 and OAT3 transporters which might contribute to the active uptake of avibactam from the blood compartment and therefore affect its excretion. Probenecid, a potent OAT inhibitor, inhibits avibactam uptake by 56–70%, potentially altering the elimination of avibactam. Since a clinical interaction trial of avibactam and probenecid has not been conducted, co-administration is not recommended.

Avibactam showed no significant inhibition of cytochrome P450 enzymes in vitro. Avibactam and ceftazidime showed no in vitro cytochrome P450 induction at clinically relevant concentrations. Avibactam and ceftazidime do not inhibit the major renal or hepatic transporters in the clinically relevant exposure range, therefore the interaction potential via these mechanisms is considered low.

Clinical data have demonstrated that there is no interaction between ceftazidime and avibactam, and between ZAVICEFTA and metronidazole.

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*ZAVICEFTA use may cause development of a positive DAGT or Coombs test, which may interfere with the cross-matching of blood and/or may cause drug induced immune haemolytic anaemia. While DAGT seroconversion in patients receiving ZAVICEFTA was very common in clinical studies (the estimated range of seroconversion across Phase III studies was 3.2% to 20.8% in patients with a negative Coombs test at baseline and at least one follow-up test), there was no evidence of haemolysis in patients who developed a positive DAGT on treatment. However, the possibility that haemolytic anaemia could occur in association with ZAVICEFTA treatment cannot be ruled out. Patients experiencing anaemia during or after treatment with ZAVICEFTA should be investigated for this possibility.5


AE, Adverse event; DAGT, direct antiglobulin test; cUTI, complicated urinary tract infection, cIAI, complicated intra-abdominal infection; HAP, hospital-acquired pneumonia; VAP, ventilator-associated pneumonia; MDR, multi-drug resistant;​​​​​​​​​​​​​​

Prescribing information​​​​​​​

Zavicefta (ceftazidime and avibactam) 2g/0.5 g Powder for Concentrate for Solution for Infusion

Meronem® (meropenem triydrate) IV 1g

Meronem® (meropenem triydrate) IV 500mg

Tazocin® (piperacillin sodium, tazobactam sodium) 2g/0.25g Powder for Solution for Infusion

Tazocin® (piperacillin sodium, tazobactam sodium) 4g/0.5g Powder for Solution for Infusion

Amikacin (amikacin sulfate)  500mg/2ml solution for injection
Legal Category: Prescription Only Medicine (POM)
NHS Price: 5 vial pack £60.00
Click here for the Summary of Product Characteristics 

Tobramycin (tobramycin)
Tobramycin 240mg/6ml solution for injection
Legal Category: Prescription Only Medicine (POM) 
Basic NHS Cost: 1 vial £19.20
Click here for the Summary of Product Characteristics

Tobramycin 80mg/2ml solution for injection 
Legal Category: Prescription Only Medicine (POM) 
Basic NHS Cost: 5 vial £20.80
​​​​​​​Click here for the Summary of Product Characteristics

Gentamicin (gentamicin sulfate) 40 mg/ml Injection
Legal Category: Prescription Only Medicine (POM)
NHS Price: 5 vial £20.00 
Click here for the Summary of Product Characteristics

Ciprofloxacin (ciprofloxacin lactate) 2 mg/ml Solution for Infusion
Legal Category: Prescription Only Medicine (POM)
NHS Price: 10 bag £200.00 
Click here for the Summary of Product Characteristics

  1. Carmeli Y, et al. Lancet Infect Dis 2016;16:661–73.
  2. Mazuski JE, et al. Clin Infect Dis 2016;62:1380–9.;
  3. Wagenlehner FM, et al. Clin Infect Dis 2016;63:754–62;
  4. Torres A, et al. Lancet Infect Dis 2018;18:285–95; 
  5. ZAVICEFTA. Summary of Product Characteristics;
  6. ​​​​​​​Mazuski JE, et al. Surg Infect 2017; 18:1-76.
PP-ZVA-GBR-0841. June 2021

Access results of ZAVICEFTA Phase III clinical trials in adult patients with cUTI, cIAI or HAP/VAP

  • REPROVE Phase III trial (HAP/VAP)

  • RECLAIM Phase III trial (cIAI)

  • RECAPTURE Phase III trial (cUTI)​​​​​​​

  • REPRISE Phase III trial (cIAI and cUTI)

Alex Soriano

Infectious Disease Physician at Hospital Clinic in Barcelona, Spain, summarises key ZAVICEFTA data against other β-lactam/β-lactamase inhibitor combinations. He discusses ZAVICEFTA’s in vitro activity and broad-spectrum coverage against MDR P. aeruginosa and Enterobacteriaceae (including Klebsiella pneumoniae, Escherichia coli and ESBL-producing strains).

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*The ABPI Code definition for healthcare professional is members of the medical, dental, pharmacy and nursing professionals and any other persons who in the course of their professional activities may administer, prescribe, purchase, recommend or supply a medicine.

PP-PFE-GBR-3863. November 2021



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