Dosing of Ceftazidime-Avibactam and Aztreonam in CRRT

Introduction to Ceftazidime-Avibactam and Aztreonam Dosing

• The European Society of Clinical Microbiology and Infectious Diseases recommends aztreonam combined with ceftazidime-avibactam for severe CRE infections caused by metallo-β-lactamase-producing organisms that are resistant to ceftazidime-avibactam monotherapy 1, 2
• The Infectious Diseases Society of America suggests that when using aztreonam-ceftazidime-avibactam combination, maintain the full 2.5 g every 8 hours dose of ceftazidime-avibactam as described above 1, 2

Clinical Application Algorithm

• For CRE with metallo-β-lactamases (NDM, VIM, IMP): Use aztreonam plus ceftazidime-avibactam combination 1, 2
• The American College of Clinical Pharmacy recommends against using tigecycline as monotherapy for bloodstream infections even if susceptible in vitro, due to low serum concentrations and higher mortality 3, 4