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Departments

— College of Medicine — Department of Internal Medicine — Divisions — Infectious Diseases — Antimicrobial Stewardship Program — Protected Antimicrobials — Ceftolozane/tazobactam (Zerbaxa)

Ceftolozane/tazobactam (Zerbaxa)

The Pharmacy and Therapeutics Committee approved the addition of ceftolozane/tazobactam (Zerbaxa) to the inpatient formulary in October 2015 with use restricted to the infectious diseases (ID) services. The drug monograph can be found at the bottom of the page.

Restriction:

All orders for ceftolozane/tazobactam must be reviewed and approved by an ID service. The ordering physician is responsible for contacting an ID service.
If ceftolozane/tazobactam is approved, ID will relay this information to the ordering physician as well as to the pharmacy. If ceftolozane/tazobactam is thought to be inappropriate, ID will provide alternative recommendations and communicate these recommendations to the physician originating the order.
ID may decide that a formal consultation is necessary for approval. In this instance, a formal ID consultation will be required for use of ceftolozane/tazobactam.

Criteria for Use:

Ceftolozane/tazobactam should only be used when there is documented or strong suspicion for infection due to multidrug-resistant Pseudomonas or Enterobacteriaceae with no alternative treatment options.
For mixed infections, ceftolozane/tazobactam must be used in combination with agents possessing gram-positive and/or anaerobic activity.

Dosing Recommendations:

Complicated urinary tract infections, including pyelonephritis: 1.5 g IV every 8 hours
Complicated intra-abdominal infections: 1.5 g IV q8h (in combination with metronidazole)
Nosocomial pneumonia: 3 g IV q8h

Creatinine Clearance	Dose Adjustment by Indication
	cUTI, cIAI	Nosocomial Pneumonia
> 50 mL/min	1.5 g IV q8h	3 g IV q8h
30-50 mL/min	750 mg IV q8h	1.5 g IV q8h
15-29 mL/min	375 mg IV q8h	750 mg IV q8h
< 15 mL/min, not on dialysis	No recommendations/not studied
ESRD on hemodialysis	750 mg IV x 1 dose followed by 150 mg IV q8h	2.25 g IV x 1 dose, followed by 450 mg IV q8h

Ceftolozane/tazobactam drug review