Ceftolozane-Tazobactam (Zerbaxa)

Indications

Complicated Intra-Abdominal Infection

  • General Comments: FDA approved in 2015
    • For use in combination with Metronidazole (Flagyl) IV (see Metronidazole, [[Metronidazole]])
  • Bacteroides Fragilis (see Bacteroides Fragilis, [[Bacteroides Fragilis]])
    • However, it has limited activity against other anaerobes
  • Extended-Spectrum Beta Lactamase (ESBL) and AmpC-Producing Organisms
  • Pseudomonas Aeruginosa (see Pseudomonas Aeruginosa, [[Pseudomonas Aeruginosa]])
    • Superior to ceftazidime
    • Ceftolozane enters Pseudomonas Aeruginosa independently of the OprD channel and therefore, is active against organisms with porin deficiencies or mutations
    • Unregulated efflux has little effect on ceftolozane as ceftolozane is not a substrate for the efflux pumps commonly found in Pseudomonas Aeruginosa
  • Streptococcus Anginosus (see Streptococcus Anginosus Group, [[Streptococcus Anginosus Group]])
  • Streptococcus Constellatus (see Streptococcus Anginosus Group, [[Streptococcus Anginosus Group]])
  • Streptococcus Salivarius (see Streptococcus Salivarius Group, [[Streptococcus Salivarius Group]])

Complicated Urinary Tract Infection (including Pyelonephritis)

  • General Comments: FDA approved in 2015
  • Extended-Spectrum Beta Lactamase (ESBL) and AmpC-Producing Organisms
  • Pseudomonas Aeruginosa (see Pseudomonas Aeruginosa, [[Pseudomonas Aeruginosa]])
    • Superior to ceftazidime
    • Ceftolozane enters Pseudomonas Aeruginosa independently of the OprD channel and therefore, is active against organisms with porin deficiencies or mutations
    • Unregulated efflux has little effect on ceftolozane as ceftolozane is not a substrate for the efflux pumps commonly found in Pseudomonas Aeruginosa

Limited Antimicrobial Activity


Pharmacology

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Metabolism

  • Renally eliminated (almost entirely by glomerular filtration), and its clearance is not affected by the addition of tazobactam (active renal tubular secretion)

Administration

  • IV: 1.5 g q8hrs (in combination with metronidazole for complicated intra-abdominal infection)

Dose Adjustment

  • Hepatic
  • Renal

Adverse Effects

Other Adverse Effects

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References

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