Cefepime 2 g + Zidebactam 1 g
Overview
The emergence of multidrug-resistant (MDR) Gram-negative bacteria has reduced the effectiveness of conventional β-lactam antibiotics. ZAYNICH (cefepime + zidebactam) is a novel antibacterial combination developed by Wockhardt. Unlike conventional β-lactam/β-lactamase inhibitor combinations, zidebactam functions as a β-lactam enhancer through complementary penicillin-binding protein (PBP) binding, improving bacterial killing.
Drug Class
Fourth-generation cephalosporin; β-lactam enhancer
Mechanism of Action
Cefepime binds primarily to PBP-3 and inhibits bacterial cell wall synthesis. Zidebactam binds strongly to PBP-2 and enhances cefepime activity by dual PBP targeting while inhibiting selected β-lactamases. Dual PBP binding (PBP-2 + PBP-3) results in rapid bacterial killing and helps overcome resistance.
Spectrum of Activity
Active against Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Citrobacter freundii, Proteus mirabilis, Serratia marcescens, Pseudomonas aeruginosa and many carbapenem-resistant Enterobacterales (based on susceptibility testing).
Approved Indications
Complicated urinary tract infection (cUTI), hospital-acquired bacterial pneumonia (HABP), ventilator-associated bacterial pneumonia (VABP), complicated intra-abdominal infections (with appropriate combination therapy), and serious MDR Gram-negative infections caused by susceptible organisms.
Adult Dose
Standard dose: Cefepime 2 g + Zidebactam 1 g IV every 8 hours. Infuse over 60 minutes. Dose adjustment is required in renal impairment.
Administration
Reconstitute according to manufacturer recommendations. Administer by IV infusion over 60 minutes. Do not mix with incompatible medications.
Adverse effects
Common: Nausea, vomiting, diarrhea, rash, headache, elevated liver enzymes and infusion-site reactions.
Serious: Hypersensitivity reactions, neurotoxicity (especially in renal impairment), seizures, Clostridioides difficile-associated diarrhea and positive Coombs test.
Drug Interactions
- Aminoglycosides – increased nephrotoxicity risk.
- Loop diuretics – monitor renal function.
- Warfarin – monitor INR.
- Other nephrotoxic agents – monitor kidney function.
