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 addition of ceftazidime/avibactam (Avycaz) was also considered and not recommended. Drug monographs can be found at the bottom of the page.
- 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.
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|