KEY POINTS
- Ceftolozane-tazobactam (Zerbaxa) is the combination of cephalosporin ceftolozane plus beta-lactamase inhibitor tazobactam
- Has activity versus Pseudomonas aeruginosa
- Is thought to be better than ceftazidime-avibactam for multidrug-resistant Pseudomonas aeruginiosa, because ceftolozane-taezobactam’s structure allows for greater bacterial membrane permeability and more stability versus AmpC beta-lactamases
- Does NOT have activity versus MRSA or VRE
- Generally a drug people look to for drug-resistant Gram negatives, especially drug-resistant Pseudomonas aeruginosa
- Has activity versus Pseudomonas aeruginosa
- Ceftolozane-tazobactam was FDA-approved December 19th, 2014
- FDA-approved for complicated intra-abdominal infection in adults, used in combination with metronidazole
- FDA-approved for complicated urinary tract infection, including pyelonephritis
- Typical dose is 1.5gm IV Q8H
- Adjust dose for renal function (CrCl < 50 mL/min)
- No adjustment for hepatic dysfunction per package insert
- Beware allergic reaction, renal toxicity, nausea, diarrhea, vomiting amidst other potential side effects
- Brand name only and fairly expensive
RESOURCES
- Ceftolozane-tazobactam Package Insert
- FDA Warning About Zerbaxa Dosing Confusion
- Ceftolozane-Tazobactam Review (Pharmacotherapy 2015)
- Ceftazidime/Avibactam and Ceftolozane/Tazobactam: Second-generation β-Lactam/β-Lactamase Inhibitor Combinations (Clin Infect Dis 2016)
- Insights On Multidrug-Resistant Pseudomonas
- IDSA Guidelines