Zavicefta: A New Hope Against Resistant Infections

Since the 1940s, antibiotics – starting with penicillin – have helped save countless lives by fighting off bacterial infections. But over the decades, many bacteria have adapted and become resistant to these life-saving medicines. Today, we’re facing a serious challenge: certain infections no longer respond to even the most powerful antibiotics we have. Experts warn that we might be entering a “post-antibiotic era,” where even minor infections could become life-threatening.¹

One of the biggest threats comes from a group of bacteria known as the gram-negative organisms. These bacteria are particularly dangerous because they have multiple defence mechanisms, including the ability to produce enzymes called beta-lactamases. These enzymes render the bacteria resistant to many common antibiotics, making treatment difficult – or sometimes impossible.¹

To tackle this, scientists have developed a promising strategy: combining beta-lactam antibiotics with special agents called beta-lactamase inhibitors, which protect the antibiotics from being destroyed. Zavicefta is one such combination that has emerged to treat serious infections caused by resistant bacteria.¹

What is the composition of Zavicefta?

Zavicefta is a powerful combination of two drugs: ceftazidime, a third-generation cephalosporin antibiotic, and avibactam, a beta-lactamase inhibitor.¹

This medication is used to treat adults with complicated infections, especially those where other antibiotics no longer work. It is approved by the United States Food and Drug Administration for the following conditions^1,2:

• Complicated urinary tract infections, including kidney infections (pyelonephritis)
• Complicated intra-abdominal infections, when used with metronidazole
• Hospital-acquired pneumonia, including ventilator-associated pneumonia

Doctors usually reserve Zavicefta for patients with limited or no alternative treatment options.¹

How does Zavicefta work?

To understand how Zavicefta works, let’s look at what each component does¹:

1. Ceftazidime: the bacteria killer

- Ceftazidime belongs to the cephalosporin family of antibiotics. It works by disrupting the bacterial cell wall, which is essential for the bacteria’s survival. This wall is made of a mesh-like structure called peptidoglycan, which gives the bacteria shape and protection.¹

- Ceftazidime binds to enzymes called penicillin-binding proteins and blocks the process of cross-linking the cell wall. Without this structure, the bacterial cell becomes unstable, leading to its death.¹

2. Avibactam: the bodyguard

- Avibactam doesn’t kill bacteria directly. Instead, it protects ceftazidime by neutralizing beta-lactamase enzymes produced by bacteria to break down antibiotics.¹

- Unlike other inhibitors such as clavulanic acid or tazobactam, avibactam has a unique structure that work against a broader range of beta-lactamase enzymes – especially those with stronger resistance.¹

Together, these two drugs make a powerful team that can take on bacteria that are resistant to almost everything else.

How is Zavicefta administered?

Zavicefta is given by intravenous (IV) infusion, meaning it goes directly into the bloodstream through the vein. Each dose is infused over 2 hours.²

Who should avoid or be cautious with Zavicefta?

Zavicefta is a strong antibiotic that’s used under close medical supervision, usually in hospitals or specialized care centres. Before starting treatment, your doctor will check to make sure it’s safe for you. Be sure to tell your doctor if any of the following apply²:- 

  - Kidney problems – Your dose may have to be adjusted so the medicine doesn’t build up in your body.

  - Allergies – Let your doctor know if you’ve had severe allergic reactions to antibiotics such as penicillin or         cephalosporins.

  - Pregnancy or breastfeeding – Your doctor will weigh the benefits and risks before prescribing Zavicefta. Always share your full medical history and medication list with your healthcare team so they can choose the safest treatment for you.

What side effects can happen?

Like all medicines, Zavicefta may cause side effects. Most are mild and manageable²:

Common side effects:

       - Nausea or vomiting, diarrhoea, headache, dizziness, elevated liver enzymes in blood tests, and allergic reactions (rash, swelling)

Serious but rare side effects:

      - Severe diarrhoea caused by a Clostridium difficile infection

      - Kidney problems, especially in people who already have kidney disease

How to store and handle Zavicefta?

Zavicefta comes as a powder that is carefully mixed with a sterile solution before IV infusion.²

Patients won’t need to handle or store Zavicefta themselves, as it is prepared and administered in a hospital or infusion centre by trained medical staff.²

How does Zavicefta compare with other antibiotics?

Zavicefta is part of a new generation of combination antibiotics developed to fight serious infections caused by drug-resistant gram-negative bacteria.²

Here’s how Zavicefta compares to other similar antibiotics:

KPC, ESBLs, AmpC, OXA-48, SHV, TEM, CTX-M, P99 and PDC are enzyme types linked to antibiotic resistance.
cIAI, complicated intra-abdominal infection; CTX-M, cefotaximase-Munich; cUTI, complicated urinary tract infection; ESBL, extended-spectrum beta-lactamase; HAP/VAP, hospital-associated pneumonia/ventilator-associated pneumonia; KPC, Klebsiella pneumoniae carbapenemase; OXA-48, oxacillinase-48; P99, Enterobacter cloacae P99; PDC, Pseudomonas-derived cephalosporinase; SHV, sulfhydryl variable.

What makes Zavicefta stand out is its ability to fight a broader range of the most dangerous drug-resistant bacteria, including those that produce beta-lactamase enzymes linked to antibiotic resistance.

Is Zavicefta accessible in India?

Zavicefta is not yet widely available in India but can be accessed through a Named Patient Program (NPP). This program allows patients with serious or life-threatening conditions to receive medicines that are approved globally but not marketed locally.⁶

Steps to access Zavicefta via NPP:

     - Doctor’s prescription – Your infectious disease specialist must confirm that no other antibiotics are working.

     - Medical justification – The doctor must explain the urgency and need for Zavicefta.

     - Regulatory approval – An application should be made to the Central Drugs Standard Control Organization.

     - Facilitator support – Partners like Rx4U India help manage import, documentation and legal compliance.

     - Cost and assistance – Although Zavicefta is expensive, some patients may receive help through insurance, hospital programs, non-governmental organizations, or crowdfunding platforms.

Final takeaway

• Zavicefta is a vital new weapon in the battle against multidrug-resistant infections.
• It combines two advanced medicines to fight bacteria that are resistant to many other antibiotics.
• While not widely available in India, patients can access it through legal import programs if no other treatments work.

Frequently asked questions

Q: Is Zavicefta safe for children?
A: Yes, Zavicefta can be given to children but requires monitoring.²

Q: How long is the treatment duration?
A: Typically, Zavicefta is given for 5 to 14 days, depending on the type and severity of infection.²

Q: Can I use Zavicefta at home?
A: No. It must be administered under medical supervision, typically in a hospital or at a specialized infusion centre.²

Q: What makes Zavicefta different from regular antibiotics?
A: Zavicefta works against bacteria that have developed resistance to most common antibiotics, offering hope for hard-to-treat infections.^1,2

Note:

The information provided is for education purpose only and is subjected to prescribing information of the drug and the guidance of your treating physician. Always consult your health care provider before making any medical decision for starting your treatment.

Disclaimer:

Rx4U procures prescribed medicines directly from manufacturers or authorized distributors. It does not claim ownership of any trademarks and complies with the provisions of the Trademark Act, 1999, particularly Sections 30 and 30(1) concerning ‘Fair Use’. It solely facilitates access to new launches through named patient import.

References:

- Zasowski EJ, Rybak JM, Rybak MJ. The β‐lactams strike back: ceftazidime‐avibactam. Pharmacotherapy. 2015;35(8):755-770.

- Prescribing information. Pfizer Healthcare Ireland Unlimited Company; 2025.

- Shirley M. Ceftazidime-avibactam: a review in the treatment of serious gram-negative bacterial infections. Drugs. 2018;78:675-92.

- McCarthy MW, Walsh TJ. Meropenem/vaborbactam fixed combination for the treatment of patients with complicated urinary tract infections. Drugs Today (Barc). 2017;53(10):521-530.

- Thakare R, Dasgupta A, Chopra S. Imipenem/cilastatin sodium/relebactam fixed combination to treat urinary infections and complicated intra-abdominal bacterial infections. Drugs Today (Barc). 2020;56(4):241-255.

- Patil S. Early access programs: Benefits, challenges, and key considerations for successful implementation. Perspect Clin Res. 2016;7(1):4-8. doi:10.4103/2229-3485.173779