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Ceftazidime\u2010avibactam is a newly approved agent combining ceftazidime and a novel \u03b2\u2010lactamase inhibitor with activity against multidrug\u2010resistant gram\u2010negative bacteria. Avibactam has increased potency and expanded spectrum of inhibition of class A and C \u03b2\u2010lactamases relative to available \u03b2\u2010lactamase inhibitors, including extended\u2010spectrum \u03b2\u2010lactamases, AmpC, and <jats:italic>Klebsiella pneumoniae<\/jats:italic> carbapenemase (<jats:styled-content style=\"fixed-case\">KPC<\/jats:styled-content>) enzymes. Avibactam expands ceftazidime's spectrum of activity to include many ceftazidime\u2010 and carbapenem\u2010resistant Enterobacteriaceae and <jats:italic>Pseudomonas aeruginosa<\/jats:italic>. Early clinical data indicate that ceftazidime\u2010avibactam is effective and well tolerated in patients with complicated urinary tract infections (<jats:styled-content style=\"fixed-case\">cUTIs<\/jats:styled-content>) and complicated intraabdominal infections (<jats:styled-content style=\"fixed-case\">cIAI<\/jats:styled-content>). In a phase <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> trial of patients with <jats:styled-content style=\"fixed-case\">cUTIs<\/jats:styled-content>, ceftazidime\u2010avibactam produced similar rates of clinical and microbiologic success compared with imipenem\u2010cilastatin (70.5% and 71.4% microbiologic success rates, respectively). Likewise, patients receiving ceftazidime\u2010avibactam plus metronidazole in a phase <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> study of patients with <jats:styled-content style=\"fixed-case\">cIAI<\/jats:styled-content> had similar response rates to those receiving meropenem (91.2% and 93.4% clinical success rates, respectively). Based on available in\u00a0vitro, in\u00a0vivo, and phase <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> trial data, as well as preliminary phase <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> trial results in ceftazidime\u2010resistant, gram\u2010negative <jats:styled-content style=\"fixed-case\">cUTI<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">cIAI<\/jats:styled-content>, ceftazidime\u2010avibactam received U.S. Food and Drug Administration approval for treatment of <jats:styled-content style=\"fixed-case\">cUTI<\/jats:styled-content>, including pyelonephritis, and <jats:styled-content style=\"fixed-case\">cIAI<\/jats:styled-content>, in combination with metronidazole, in adult patients with limited or no alternative treatment options. The approved dosage, ceftazidime 2\u00a0g\u2013avibactam 0.5\u00a0g administered as a 2\u2010hour infusion every 8\u00a0hours, was selected based on pharmacodynamic analysis and available clinical data. This dosage is under further investigation in patients with <jats:styled-content style=\"fixed-case\">cUTI<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> cIAI<\/jats:styled-content>, and nosocomial or ventilator\u2010associated pneumonia. The current body of evidence suggests that ceftazidime\u2010avibactam is a promising addition to our therapeutic armamentarium with potential to answer an urgent unmet medical need. Further data in highly resistant gram\u2010negative infections, particularly those caused by <jats:styled-content style=\"fixed-case\">KPC<\/jats:styled-content>\u2010producing Enterobacteriaceae, are needed. As it is introduced into clinical use, careful stewardship and rational use are essential to preserve ceftazidime\u2010avibactam's potential utility.<\/jats:p>","DOI":"10.1002\/phar.1622","type":"journal-article","created":{"date-parts":[[2015,8,19]],"date-time":"2015-08-19T22:59:32Z","timestamp":1440025172000},"page":"755-770","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":200,"title":["The \u03b2\u2010Lactams Strike Back: Ceftazidime\u2010Avibactam"],"prefix":"10.1002","volume":"35","author":[{"given":"Evan J.","family":"Zasowski","sequence":"first","affiliation":[{"name":"Anti\u2010Infective Research Laboratory Department of Pharmacy Practice Eugene Applebaum College of Pharmacy and Health Sciences Wayne State University Detroit Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Rybak","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy University of Tennessee Memphis Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Rybak","sequence":"additional","affiliation":[{"name":"Anti\u2010Infective Research Laboratory Department of Pharmacy Practice Eugene Applebaum College of Pharmacy and Health Sciences Wayne State University Detroit Michigan"},{"name":"Department of Medicine Division of Infectious Diseases School of Medicine Wayne State University Detroit Michigan"},{"name":"Department of Pharmacy Services Detroit Medical Center Detroit Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,8,19]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"(CDC) CfDCaP.Antibiotic resistance threats in the United States 2013 2014. 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