Medications
Ceftazidime / avibactam (Avycaz)
A hospital antibiotic given by intravenous infusion (Avycaz) that pairs ceftazidime (a cephalosporin) with avibactam (which shields it from many bacterial enzymes, including some carbapenem-destroying ones); it treats complicated belly and urinary infections and hospital-acquired pneumonia. It is a clinician-given infusion, so its usual Medicare path is Part B; the Part D aggregation is carried exactly as the formulary file computes it.
How Medicare covers it
Part B (clinician-given intravenous infusion — HCPCS J0714 in the CMS Part B spending file, see the Part B basis in this package). Part D aggregation carried exactly. Part A during a covered inpatient stay.
| Coverage details | |
|---|---|
| Part B status | CMS Part B Spending by Drug HCPCS file (RY26, data through 2024) carries J0714 (injection, ceftazidime and avibactam, 0.5 g/0.125 g): the clinician-given intravenous path has a Part B basis and is this drug's usual path (daptomycin/cefepime precedent). The single-ingredient ceftazidime row J0713 is explicitly NOT matched to this combination package. |
| Medicare Advantage | Most Medicare Advantage plans that include drug coverage (MAPD plans) use the same formulary-and-tier system; the plan's own drug list decides coverage and copay — check the plan's formulary. |
| Medicare Supplement (Medigap) | Medicare Supplement (Medigap) plans sold today do not include prescription drug coverage; drug coverage comes from Part D or an MAPD plan. |
What it treats
Serious infections caused by certain Gram-negative bacteria in adults and children (at least 31 weeks gestational age): complicated intra-abdominal (belly) infections — used together with metronidazole — complicated urinary tract infections including pyelonephritis (a kidney infection), and hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (lung infections that start in the hospital or on a breathing machine). Brand name Avycaz.
What it is for, in depth
Avycaz is an intravenous antibiotic that combines ceftazidime, a cephalosporin, with avibactam, a drug that protects ceftazidime from being broken down by resistant bacteria. It is prescribed for adults and for children from at least 31 weeks gestational age who have serious Gram-negative infections: complicated infections inside the belly (given with metronidazole), complicated urinary tract infections including kidney infection (pyelonephritis), and pneumonia that starts in the hospital or while on a ventilator. It fits later in the treatment path when the bacteria are resistant or suspected to be resistant to plainer antibiotics, and it should only be used when the infection is proven or strongly suspected to be caused by bacteria it can treat. It comes only as a single-dose vial of powder — 2.5 grams total (ceftazidime 2 grams and avibactam 0.5 grams) — that is mixed and infused into a vein over 2 hours, usually every 8 hours.
How it works
It combines two drugs. Ceftazidime is a cephalosporin antibiotic: it kills bacteria by binding to penicillin-binding proteins the bacteria need to build their cell walls. Avibactam is a beta-lactamase inhibitor: it shuts down certain beta-lactamase enzymes that bacteria use to break down ceftazidime, so ceftazidime can keep working against bacteria that make those enzymes (including some ESBL, KPC, AmpC and certain OXA enzymes). Avycaz is not active against bacteria that produce metallo-beta-lactamases.
How it is taken
Given in a hospital or clinic as an intravenous (IV) infusion into a vein over 2 hours, usually every 8 hours. For adults with normal kidney function the dose is 2.5 grams (ceftazidime 2 grams and avibactam 0.5 grams); the dose is lowered and spaced out further when the kidneys do not work as well. Treatment usually lasts 5 to 14 days for belly infections and 7 to 14 days for urinary tract infections and hospital pneumonia. For belly infections, metronidazole is given at the same time.
Common side effects
In adults, the most common side effects depend on the infection treated: with belly infections (with metronidazole) diarrhea, nausea and vomiting occurred in 5% or more; with urinary tract infections diarrhea and nausea occurred in 3%; with hospital pneumonia diarrhea and vomiting occurred in 5% or more. In children 3 months and older the most common (3% or more) were vomiting, diarrhea, rash and infusion-site phlebitis (vein irritation); in babies under 3 months they were vomiting and increased transaminases (liver tests).
Serious warnings
Serious and sometimes fatal allergic (hypersensitivity) reactions, including anaphylaxis and serious skin reactions, have been reported with beta-lactam antibiotics — tell the care team about any allergy to cephalosporins, penicillins or carbapenems before treatment, because cross-sensitivity can occur, and the drug is stopped if an allergic reaction happens. Clostridioides difficile-associated diarrhea (CDAD), ranging from mild diarrhea to fatal colitis, has been reported with nearly all systemic antibacterials including Avycaz and can occur more than 2 months after treatment, so diarrhea during or after treatment must be evaluated. Seizures and other nervous-system reactions (including encephalopathy, coma and myoclonia) can occur, especially in patients with kidney impairment whose dose is not adjusted. In one belly-infection trial, cure rates were lower and deaths were higher in a subgroup with moderately reduced kidney function who received a dose that was too low, so kidney function is monitored at least daily and the dose adjusted as it changes.
Who should be careful
People with kidney impairment need a lower dose, with kidney function checked at least daily while it is changing — both drugs are removed by dialysis, so Avycaz is given after hemodialysis on dialysis days. People with a known serious allergy to Avycaz components, avibactam-containing products or other cephalosporins must not receive it. Avycaz should only be used for infections proven or strongly suspected to be caused by susceptible bacteria, to reduce the development of drug-resistant bacteria.
Major interactions
Probenecid is not recommended with Avycaz: probenecid blocks the OAT1/OAT3 transporters that help remove avibactam from the blood and can decrease avibactam elimination by 56% to 70% in laboratory studies. Ceftazidime can also cause a false-positive result for glucose (sugar) in the urine with certain test methods, so glucose tests based on enzymatic glucose oxidase reactions should be used.
Cost and saving notes
Avycaz is given by IV infusion in a hospital or clinic, so it is often handled under medical (hospital) coverage rather than as a home Part D prescription; ask the hospital and your plan which part of Medicare covers it and what your share will be. If a Part D plan does cover a related drug cost and it is high, you can ask for a tier exception, and Extra Help (the Part D Low-Income Subsidy) can lower drug costs for people with limited income. In 2027, what you pay out of pocket for Part D drugs is capped at $2,400 for the year, and the Medicare Prescription Payment Plan lets you spread Part D costs in monthly payments.
Why it is in its tier
Ceftazidime / avibactam (Avycaz) sits on Tier 4 in 42.05% of the plans that list it (37 of 88 listing plans). Tier 4 is the non-preferred tier — higher copays or coinsurance. The data-visible drivers: It is a brand-only product with no generic version in the formulary data, and the CMS dashboard puts its average Part D spending at about $17,394 per beneficiary for 2024 — a high-cost drug, which matches where plans place it. Only 1.6% of Part D plans list it at all, so many readers will find their plan does not list it and covers a similar drug instead. The tier shown is the most common one; individual plans vary.
Sources
- AVYCAZ (CEFTAZIDIME, AVIBACTAM) POWDER, FOR SOLUTION [ALLERGAN, INC.] — DailyMed
- MedlinePlus — National Library of Medicine
- MedlinePlus — Ceftazidime and Avibactam Injection
What official patient guides say
In everyday treatment, ceftazidime and avibactam is given as an intravenous infusion, not by mouth. The powder is added to fluid and infused slowly into a vein over 2 hours, usually every 8 hours, for a length of time your doctor sets based on your health, the type of infection, and how you respond. You may receive it in a hospital, or at home after your healthcare provider shows you how to use it — be sure you understand those directions and ask questions. You should begin to feel better during the first few days; tell your doctor if symptoms do not improve, get worse, or remain after you finish. Continue your normal diet unless told otherwise, and keep doctor and laboratory appointments. If you have diabetes, the page notes this medicine can cause false results with certain urine glucose tests, so ask your doctor which tests to use during treatment.
Part D formulary coverage
| Formulary summary | |
|---|---|
| Most common tier | 4 |
| Plans listing this drug | 88 |
| Total Part D plans | 5495 |
| Share of plans listing it | 1.6 |
| Formularies listing it | 6 |
| Tier | Plans |
|---|---|
| Tier 1 | 21 plans |
| Tier 4 | 37 plans |
| Tier 5 | 30 plans |
Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.
What you pay
| With Medicare Part D | |
|---|---|
| Most common tier | Tier 4 |
| Typical coinsurance | 33.0% of the price |
| Based on | 37 plans that cover this drug · 2027 plan year |
A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.
Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-07
Similar medications
Other medications in the same FDA pharmacologic class (Cephalosporin Antibacterial):
- Cefaclor
- Cefadroxil (Duricef and others)
- Cefazolin sodium injection
- Cefdinir (Omnicef and others)
- Cefepime injection (Maxipime and others)
- Cefixime (Suprax and others)
- Cefotetan
- Cefoxitin
- Cefpodoxime (Vantin and others)
- Ceftaroline fosamil (Teflaro)
- Ceftazidime (Tazicef, Fortaz)
- Ceftobiprole Medocaril (Zevtera)
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Part D spending averages (2024)
| Brand name | Generic name | Total claims 2024 | Total spending 2024 | Total beneficiaries 2024 | Rank by beneficiaries 2024 |
|---|---|---|---|---|---|
| Avycaz | Ceftazidime/Avibactam | 4263 | 1.95334e+07 | 1123 | 1767 |
Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30
Companies covering this drug
88 plans from 19 companies list this drug on a formulary for 2027. Search by company or plan name, or filter by tier. Cost sharing is the plan's published amount for this drug's tier in the initial coverage stage (1-month retail supply), where the plan publishes it; a blank means the plan does not publish it.
| Company | Plan | Tier | Copay | Coinsurance |
|---|
A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.
Coverage and costs change. Drug lists (formularies), tiers, and copays can change during the year and differ by plan. Always check with your insurance company or plan directly to confirm what is covered and what you will pay.
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