It was developed mainly to tackle hard-to-treat, multidrug-resistant Gram-negative infections, especially when bacteria produce enzymes (beta-lactamases) that would normally break down many beta-lactam antibiotics. Avibactam helps protect aztreonam against several key beta-lactamases, thereby restoring activity against resistant organisms.

European Union (EU): Marketing authorisation granted on 22 April 2024.

United States (US FDA): Approved on 7 February 2025 for adult complicated intra-abdominal infections with limited or no treatment options, in combination with metronidazole.

1. Treatment of serious infections caused by susceptible multidrug-resistant Gram-negative bacteria.

2. Management of complicated infections where beta-lactamase-producing organisms are suspected or confirmed.

Aztreonam works by inhibiting bacterial cell wall synthesis, leading to bacterial cell lysis. However, many resistant bacteria produce β-lactamase enzymes that can inactivate aztreonam. Avibactam blocks these enzymes, preventing the breakdown of aztreonam. This combination restores and extends antibacterial activity, allowing effective treatment of resistant infections.

Aztreonam, Avibactam.NMP is given only as an intravenous (IV) infusion, under medical supervision.

Administration

• Given as a drip directly into a vein (IV infusion).

• Infusion duration is 3 hours.

• The dosing interval is usually calculated from the start of one infusion to the start of the next.

Typical adult dosing (standard renal function)

• Common label dosing includes a higher first dose (loading dose) followed by maintenance doses every 6 hours.

Kidney impairment

• Dose adjustment is required in renal impairment and dosing changes depend on creatinine clearance.

• On haemodialysis days, administration timing may be adjusted (often after dialysis).

Duration

• Treatment duration commonly ranges 5 to 14 days, based on infection type, severity, clinical response, and culture results.

Like all antibiotics, this medicine can cause side effects, although not everyone gets them.

Serious side effects (need urgent medical help)

• Severe allergic reactions: rash, facial swelling, wheezing, breathing difficulty.
  

• Severe or persistent diarrhoea, especially if watery or bloody (possible C. difficile).
  

• Significant liver enzyme elevations or symptoms of liver injury in susceptible patients.

Common or clinically relevant side effects that may occur

• Gastrointestinal upset including diarrhoea.
  

• Infusion related reactions or rash in some patients.
  

• Hypersensitivity reactions: Serious allergic reactions can occur. Stop the infusion and seek urgent care if rash, swelling, wheezing, or breathing difficulty develops.
  

• Clostridioides difficile-associated diarrhoea: Persistent diarrhoea after antibiotics can be serious and needs medical review.
  

• Liver enzyme elevations: Monitor liver function in appropriate patients, especially those with liver comorbidities or who are on other hepatotoxic medications.
  

• Antibiotic resistance risk: Inappropriate use can drive resistance and secondary infections, so treatment should be guided by cultures and clinical response.

• Kidney function monitoring: Dose changes are needed in renal impairment and when kidney function is changing. Regular monitoring is important.
  

• Tell your doctor about past beta-lactam allergy: Even if the reaction was years ago, it matters.
  

• Do not self-medicate: This is a hospital antibiotic. It must be used only under specialist supervision.
  

• Pregnancy and breastfeeding: Use only if clearly advised by a specialist after risk-benefit assessment.
  

• Drug interactions and comorbidities: Share the full medication list and history (including liver disease, kidney disease, and prior antibiotic reactions) before starting therapy. 

1. Take the medicine exactly as prescribed by your doctor.

2. Do not stop treatment early, even if symptoms improve.

3. Inform your doctor immediately if you develop a rash, breathing difficulty, or severe diarrhoea.

4. Ensure regular monitoring if you have kidney-related conditions.

5. Avoid self-medication and sharing this medicine with others.

1. Al Musawa M, Bleick CR, Herbin SR, Caniff KE, Van Helden SR, Rybak MJ. Aztreonam-avibactam: The dynamic duo against multidrug-resistant gram-negative pathogens. Pharmacotherapy. 2024;44(12):927-938. doi:10.1002/phar.4629

2. Delp, H., Gibson, G. A., & Buckman, S. A. (2024). Aztreonam-avibactam for the treatment of intra-abdominal infections. Expert opinion on pharmacotherapy, 25(14), 1867–1872. https://doi.org/10.1080/14656566.2024.2409950

3. Wong DW. Practical Application of Aztreonam-Avibactam as a Treatment Strategy for Ambler Class B Metallo-β-Lactamase Producing Enterobacteriaceae. Antibiotics (Basel). 2024;13(8):766. Published 2024 Aug 14. doi:10.3390/antibiotics13080766

Aztreonam–avibactam is a next-generation antibiotic combination designed to treat multidrug-resistant Gram-negative infections. Avibactam protects aztreonam from beta-lactamase enzymes, restoring activity against resistant bacteria. It was approved in the EU in April 2024 and by the US FDA in February 2025 for adult complicated intra-abdominal infections with limited treatment options.

The drug information on this page is not a substitute for medical advice. It is meant for educational purposes only. For further details, consult your doctor about your medical condition to know if you can receive this treatment.