avibactam avibactam avibactam is a non-β-lactam β-lactamase inhibitor developed by actavis (now teva) jointly with astrazeneca. a new drug application for avibactam in combination with ceftazidime (branded as avycaz) was approved by the fda on february 25, 2015, for treating complicated urinary tract (cuti) and complicated intra-abdominal infections (ciai) caused by antibiotic resistant-pathogens, including those caused by multi-drug resistant gram-negative bacterial pathogens. avibactamclinical datatrade namesavycaz (formulated with ceftazidime)license data eu ema: by inn routes ofadministrationivatc codenonelegal statuslegal status us: ℞-only pharmacokinetic databioavailability100% (intravenous)protein binding5.7–8.2%metabolismnilonset of actionincreases in proportion to doseexcretionrenal (97%)identifiers iupac name octan-6-yl] hydrogen sulfate cas number1192500-31-4pubchem cid9835049chemspider8010770unii7352665165keggd10340chebichebi:85984 ychemblchembl1689063chemical and physical dataformulac7h11n3o6smolar mass265.24 g·mol−13d model (jsmol)interactive image smiles 12c((cc1)c(n)=o)c(=o)n2os(o)(=o)=o inchi inchi=1s/c7h11n3o6s/c8-6(11)5-2-1-4-3-9(5)7(12)10(4)16-17(13,14)15/h4-5h,1-3h2,(h2,8,11)(h,13,14,15)/t4-,5+/m1/s1key:ndcuapjvlwfhhb-uhnvwzdzsa-n increasing resistance to cephalosporins among gram-(−) bacterial pathogens, especially among hospital-acquired infections, results in part from the production of β-lactamase enzymes that deactivate these antibiotics. while the co-administration of a β-lactamase inhibitor can restore antibacterial activity to the cephalosporin, previously approved β-lactamase inhibitors such as tazobactam and clavulanic acid do not inhibit important classes of β-lactamases, including klebsiella pneumoniae carbapenemases (kpcs), new delhi metallo-β-lactamase 1 (ndm-1), and ampc-type β-lactamases. whilst avibactam inhibits class a (kpcs, ctx-m, tem, shv), class c (ampc), and, some, class d serine β-lactamases (such as oxa-23, oxa-48), it has been reported to be a poor substrate/weak inhibitor of class b metallo-β-lactamases, such as vim-2, vim-4, spm-1, bcii, ndm-1, fez-1. for infections sustained by metallo-β-lactamases producing bacteria, a therapeutic strategy consists in administering avibactam as companion drug administered alongside aztreonam. in fact, although in theory aztreonam is not hydrolyzed by metallo-β-lactamases, many metallo-β-lactamases-producing strains co-produce enzymes that could hydrolyze aztreonam (e.g. ampc, esbl), therefore avibactam is given to protect aztreonam exploiting its robust β-lactamases inhibition.