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This section of the website is for UK healthcare professionals only. If you are not a healthcare professional, please click here.

Updated on 13/03/2019

ANTIBIOTICS

ZERBAXA is indicated for the treatment of the following infections in adults:1

  • Complicated intra-abdominal infections
  • Complicated urinary tract infections
  • Acute pyelonephritis

Consideration should be given to official guidance on the appropriate use of antibacterial agents.

STRUCTURE

Ceftolozane is structurally similar to ceftazidime with modified side chains that enhance anti-pseudomonal activity2

Aminothiadiazole ring 7-position side chain enhances activity against Gram‑negative bacilli2 Pyrazole ring on the 3-position side-chain confers stability against AmpC ß-lactamases in P. aeruginosa2 Oxime confers ß-lactamases stability2 Dimethylacetic acid enhances anti‑pseudomonal activity2

Adapted from Zhanel et al. 2014.2

DOSING

The recommended dose regimen of ZERBAXA for injection is 1.5 g (1 g/0.5 g) administered every 8 hours by IV infusion over 1 hour in patients 18 years or older1

Table 1: Dose of ZERBAXA by infection in patients with creatinine clearance (CrCl) greater than 50 mL/min1

Infection Dose Frequency Infusion time Duration of treatment
Complicated intra-abdominal infectionsa 1 g ceftolozane/
0.5 g tazobactam
Every 8 hours 1 hour 4 to 14 days
Complicated urinary tract infections, including acute pyelonephritis 1 g ceftolozane/
0.5 g tazobactam
Every 8 hours 1 hour 7 days

Adapted from ZERBAXA Summary of Product Characteristics.
aTo be used in combination with metronidazole when anaerobic pathogens are suspected.

Because ZERBAXA is eliminated primarily by the kidneys, a dose adjustment is required for patients whose CrCl is 50 mL/min or less, as shown below1

Table 2: Dose of ZERBAXA in patients with renal impairment1

Estimated CrClb (mL/min) Recommended dose regimen for ZERBAXA**
30-50 500 mg ceftolozane / 205 mg tazobactam intravenously every 8 hours
15-29 250 mg ceftolozane / 125 mg tazobactam intravenously every 8 hours
End-stage renal disease (ESRD) on haemodialysis days (HD) A single loading dose of 500 mg ceftolozane / 250 mg tazobactam followed after 8 hours by a 100 mg ceftolozane / 50 g tazobactam maintenance dose administered every 8 hours for the remainder of the treatment period (on haemodialysis days, the dose should be administered at the earliest possible time following completion of haemodialysis

Adapted from ZERBAXA Summary of Product Characteristics.
bCrCl estimated using Cockcroft-Gault formula.
**All doses of ZERBAXA are administered intravenously over 1 hour and are recommended for all indications. The duration of treatment should follow the recommendations in Table 1.

BREAKPOINTS

Breakpoints established by the European Committee on Antimicrobial Susceptibility Testing (EUCAST)3

Minimum inhibitory concentration (MIC) breakpoints established by the European Committee on Antimicrobial Susceptibility Testing (EUCAST)3

EUCAST breakpoints MIC breakpoint (mg/L) Disc content
(µg)
Zone diameter breakpoint (mm)
S≤ R> S≥ R<
Pseudomonas aeruginosa3 4a 4a 30-10 24 24
Enterobacteriaceae3 1a 1a 30-10 23 23

Adapted from The European Committee on Antimicrobial Susceptibility Testing 2018.3
a For susceptibility testing purposes, the concentration of tazobactam is fixed at 4 mg/L.

TESTING

ZERBAXA susceptibility testing

MIC GRADIENT STRIPS

DISC TESTING

  • MAST: Ceftolozane/tazobactam (C/T40C) AST stock discs available in packs containing 5 x 50 discs and compatible with Mast’s new DiscMaster 4 disc dispenser (MDD64)
  • Contact Mast for more information on sales@mastgrp.com or
    0151 472 1444

AUTOMATED TESTING

  • Please contact BioMerieux to register your interest for updating the formulation of the Gram Negative AST cards to include ceftolozane/ tazobactam. Contact
    01256 461 881
  • Please contact Becton Dickinson to register your interest for updating the formulation of the susceptibility panel for ceftolozane/tazobactam. Contact Orders.uk@europe.bd.com or 01865 781 666

References

  1. ZERBAXA Summary of Product Characteristics.
  2. Zhanel GG et al. Ceftolozane/Tazobactam: A Novel Cephalosporin/b-Lactamase Inhibitor Combination with Activity Against Multidrug-Resistant Gram-Negative Bacilli Drugs 2014;58:31–51.
  3. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 8.0 2018 http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_8.0_Breakpoint_Tables.pdf

Supporting documentation

Prescribing Information | Summary of Product Characteristics | Patient Information Leaflet

GB-ZER-00021 | Date of Preparation: March 2019