Efficacy and Pharmacodynamic Target Attainment for Ceftazidime-Avibactam Off-Label Dose Regimens in Patients with Continuous or Intermittent Venovenous Hemodialysis: Two Case Reports

Limited data are available for ceftazidime-avibactam (CZA) dosing in patients receiving renal replacement therapy, especially the data on the dosing in patients receiving intermittent hemodialysis (IHD). In this report, we firstly described a case in which CZA was administered as 2.5 g after each time of IHD, and a dose of 1.25 g was added on the 48(th)-hour for the 72-h interdialytic interval. Plasma concentrations of CZA measured at different time indicated that > 50% of administered ceftazidime and avibactam were removed during the 4-h hemodialysis. In addition, we described another case on continuous venovenous hemodialysis (CVVHD), in which CZA was administered as 2.5 g q12h in 2-h infusions. The dose regimen for these two cases could achieve trough concentration of ceftazidime higher than fourfold of the MIC and trough concentration of avibactam higher than the threshold of 1 mu g/mL during the treatment, and exert efficient antimicrobial effect.

Automated summary

This article describes two cases of patients receiving renal replacement therapy who were treated with ceftazidime-avibactam. In the case of intermittent hemodialysis (IHD), 2.5 g of CZA was administered after each session of IHD, with an additional dose of 1.25 g given during the interdialytic interval. In the case of continuous venovenous hemodialysis (CVVHD), 2.5 g of CZA was given every 12 hours in 2-hour infusions. Both dosing regimens maintained effective drug concentrations and exerted antimicrobial effects during the treatment.