Introduction Cerebral palsy patients are at high risk for developing recurrent pneumonia with increased morbidity and mortality. Frequent requirements of antibiotics have resulted in multidrug resistant (MDR) pathogens. Newer antibiotics can help treat these infections, but many contain beta lactam rings and less information is known about tolerability. This abstract describes a penicillin tolerant cerebral palsy patient who developed a type I hypersensitivity reaction to ceftazidime/avibactam, and his successful treatment with this antibiotic after rapid induction of temporary tolerance. Case Description A 34-year old male with cerebral palsy was admitted for sigmoidectomy after a diagnosis of colon adenocarcinoma. During his hospitalization, he developed multifocal pneumonia with MDR Klebsiella. Infectious Disease deemed ceftazidime/avibactam the only acceptable antibiotic for treatment. The first infusion of the antibiotic resulted in immediate flushing and urticaria, which was successfully treated with H1 antihistamines. Allergy was consulted for rapid induction of temporary tolerance. A 16-step protocol was successfully completed based on the Journal of Cystic Fibrosis model. The patient continued to tolerate this medication throughout his recovery. He had no prior documented exposure to ceftazidime or aztreonam. Discussion This is the first reported case in the literature to describe a type I hypersensitivity reaction and rapid intravenous induction of tolerance to ceftazidime/avibactam. Interestingly this patient previously tolerated penicillins and cephalosporins without similar reaction, suggesting the possibility of a non-IgE mediated mechanism to the hypersensitivity reaction. Additional information regarding non-irritating doses of avibactam could help clarify the culprit agent in order to guide further avoidance recommendations.