Phase 1 study assessing the steady-state concentration of ceftazidime and avibactam in plasma and epithelial lining fluid following two dosing regimens

Objectives: The aim of this Phase 1, open-label study (NCT01395420) was to measure and compare concentrations of ceftazidime and avibactam in bronchial epithelial lining fluid (ELF) and plasma, following administration of two different dosing regimens in healthy subjects. Patients and methods: Healthy volunteers received 2000 mg of ceftazidime+500 mg of avibactam (n = 22) or 3000 mg of ceftazidime+1000 mg of avibactam (n = 21), administered intravenously every 8 h for 3 days (total of nine doses). Bronchoscopy with bronchoalveolar lavage was performed once per subject, 2, 4, 6 or 8 h after the last infusion. Pharmacokinetic parameters were estimated from individual plasma concentrations and the composite ELF concentration-time profile. Safety was assessed. Results: Forty-three subjects received treatment (2000 mg of ceftazidime+500 mg of avibactam, n = 22; 3000 mg of ceftazidime+1000 mg of avibactam, n = 21). Plasma and ELF concentrations increased dose-proportionally for both drugs, with 1.5- and 2-fold increases in AUC(tau), for respective components. Ceftazidime C-max and AUC(tau) in ELF were similar to 23%-26% and 31%-32% of plasma exposure. Avibactam C-max and AUC(tau) in ELF were similar to 28%-35% and 32%-35% of plasma exposure. ELF and plasma elimination were similar for both drugs. No serious adverse events were observed. Conclusions: Both ceftazidime and avibactam penetrated dose-proportionally into ELF, with ELF exposure to both drugs similar to 30% of plasma exposure.