Ceftolozane with tazobactam (Zerbaxa®)
General Information
Cephalosporin and beta-lactamase inhibitor antibiotic
Do NOT use if patient has a history of severe penicillin allergy. If in doubt, discuss with Micro/ID.
Restricted formulary antimicrobial: Must be recommended/prescribed by a Micro/ID consultant or registrar.
AWaRe antibiotic classification: 'Reserve'. All indications to be discussed with Micro/ID.
Note: There is an EPR powerplan associated with this drug.
For all information regarding interactions, contraception, pregnancy and breastfeeding and additional information, see BNF.
Standard dose
| Indication | Intravenous dose |
| Non-respiratory infections |
1g ceftolozane/ 0.5g tazobactam (1.5g) TDS |
| Hospital-acquired pneumonia (HAP) or Ventilator-associated pneumonia (VAP) |
2g ceftolozane/ 1g tazobactam (3g) TDS |
- Each vial contains 1g ceftolozane + 0.5g tazobactam
- Higher dose (HAP or VAP) of 3g ceftolozane-tazobactam is 2g ceftolozane + 1g tazobactam which is 2 vials.
Obesity
No dose adjustment required
Renal and hepatic impairment
Renal impairment
|
Creatinine Clearance* (mL/min) |
Where usual dose would be 1.5g TDS (1g ceftolozane / 500mg tazobactam) |
Where usual dose would be 3g TDS (2g ceftolozane / 1g tazobactam) |
Frequency |
| 51 and above |
Dose as in normal renal function |
||
| 30-50 |
500 mg ceftolozane / 250 mg tazobactam (750 mg) |
1 g ceftolozane / 500 mg tazobactam (1.5 g) |
TDS |
| 15-29 |
250 mg ceftolozane / 125 mg tazobactam (375 mg) |
500 mg ceftolozane / 250 mg tazobactam (750 mg) |
TDS |
|
Less than 15 |
A single loading dose of: 500 mg ceftolozane / 250 mg tazobactam (750 mg)
Followed 8 hours later with maintenance dose: 100 mg ceftolozane / 50 mg tazobactam (150 mg) |
A single loading dose of: 1.5 g ceftolozane / 750 mg tazobactam (2.25 g)
Followed 8 hours later with maintenance dose: 300 mg ceftolozane / 150 mg tazobactam (450 mg) |
maintenance dose is TDS |
|
HDF/High flux/PD |
Dialysed; give post-dialysis on dialysis days** Dose as in CrCl less than 15 ml/min |
||
*dose ranges use creatinine clearance, rather than eGFR.
**on haemodialysis days, the dose should be administered at the earliest possible time following completion of haemodialysis
Hepatic impairment
No dose adjustment required
References
- Merck Sharp & Dohme (UK) Limited. Zerbaxa 1g/0.5g Powder for concentration for solution for Infusion summary of product characteristics. Electronic medicines compendium. Last revision of the text 14/08/2023. Accessed via www.medicines.org.uk Accessed 3/2/26.
- British National Formulary. Ceftolozane with tazobactam. Accessed via: BNF online accessed via www.medicinescomplete.com. Accessed 3/2/26.
- The Renal Drug Database. ZERBAXA (ceftolozane and tazobactam sodium). Last updated 24/09/24. Accessed via https://renaldrugdatabase.com. Accessed 3/2/26
- Sanford Guide [online]. Ceftolozane-tazobactam. Last updated 23/1/26. Accessed via https://webedition.sanfordguide.com. Accessed 3/2/26.
- Sanford Guide [online]. Obesity dosing adjustment. Last updated 21/1/26. Accessed via https://webedition.sanfordguide.com Accessed 3/2/26