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 and Summary of Product Characteristics (SPC).
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