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Ceftolozane with tazobactam parenteral

Updated 2 Feb 2023 | Cephalosporins


Infusions of ceftolozane (as ceftolozane sulfate) with tazobactam (as tazobactam sodium).

Drugs List

  • ceftolozane 1g and tazobactam 500mg powder for concentrate for solution for infusion
  • ZERBAXA 1g + 0.5g powder for concentrate for solution for infusion
  • Therapeutic Indications


    Complicated intra-abdominal infections: treatment
    Complicated urinary tract infections
    Hospital-acquired pneumonia (HAP)



    Complicated intra-abdominal infection
    1g ceftolozane/500mg tazobactam every 8 hours. The manufacturer suggests a treatment duration of 4 to 14 days.

    If anaerobic pathogens are suspected, use in combination with metronidazole. See information for metronidazole for more details.

    Complicated urinary tract infection
    1g ceftolozane/500mg tazobactam every 8 hours. The manufacturer suggests a treatment duration of 7 days.

    Acute pyelonephritis
    1g ceftolozane/500mg tazobactam every 8 hours. The manufacturer suggests a treatment duration of 7 days.

    Hospital-acquired pneumonia (HAP) including ventilator-associated penumonia
    2g ceftolozane/1g tazobactam every 8 hours. The manufacturer suggests a treatment duration of 8 to 14 days.

    Patients with Renal Impairment

    Creatinine clearance estimated using Cockcroft-Gault formula.

    Creatinine clearance 30 to 50 ml/minute
    500mg ceftolozane/250mg tazobactam every 8 hours.

    Creatinine clearance 15 to 29 ml/minute
    250mg ceftolozane/125mg tazobactam every 8 hours.

    End stage renal disease on haemodialysis
    Single loading dose of 500mg ceftolozane/250mg tazobactam. Follow after 8 hours with a maintenance dose of 100mg ceftolozane/50mg tazobactam administered every 8 hours for remainder of treatment.

    On haemodialysis days, administer dose at earliest possible time following completion of haemodialysis.


    Intravenous infusion over 1 hour.


    Children under 18 years

    Precautions and Warnings

    Restricted sodium intake
    End stage renal disease
    Renal impairment - creatinine clearance below 50ml/minute

    Reduce dose in patients with creatinine clearance below 50ml/min
    Sodium content of formulation may be significant
    Advise ability to drive/operate machinery may be affected by side effects
    Before initiating therapy enquire about previous hypersensitivity reactions
    Consult national/regional policy on the use of anti-infectives
    Concentrate must be diluted and used as an infusion
    Monitor for signs of superinfection with non-susceptible organisms
    Monitor periodically for overgrowth of non-susceptible organisms
    Consider pseudomembranous colitis if patient presents with diarrhoea
    Test interference: May cause false positive Coombs test
    Discontinue if severe hypersensitivity reactions occur
    Discontinue therapy if marked diarrhoea occurs

    Pregnancy and Lactation


    Use ceftolozane with tazobactam with caution during pregnancy.

    The manufacturer suggests ceftolozane with tazobactam should only be used if the expected benefit outweighs the possible risks. Tazobactam crosses the placenta. It is not known if ceftolozane crosses the placenta. Animal studies with tazobactam have shown reproductive toxicity without evidence of teratogenic effects. At the time of writing there is limited published information on the use of ceftolozane with tazobactam in pregnant women. Potential risks are unknown.


    Use ceftolozane with tazobactam with caution during breastfeeding.

    The manufacturer suggests a decision must be made whether to discontinue breastfeeding or discontinue ceftolozane with tazobactam taking into account the benefit of therapy and the benefit of breastfeeding the child. At the time of writing, it is unknown whether ceftolozane and tazobactam are excreted in human milk. A risk to newborns cannot be excluded.

    The Drugs and Lactation Data (LactMed) suggests ceftolozane with tazobactam is acceptable for use during breastfeeding. No serious adverse effects have been reported for other cephalosporin antibiotics, occasionally disruption of the child's gastrointestinal flora, resulting in diarrhoea or thrush have been reported.

    Side Effects

    Abdominal distension
    Abdominal pain
    Alanine aminotransferase increased
    Angina pectoris
    Aspartate aminotransferase increased
    Atrial fibrillation
    Clostridium difficile diarrhoea
    Gamma glutamyl transferase (GGT) increased
    Increase in alkaline phosphatase
    Injection site reactions
    Ischaemic stroke
    Oropharyngeal candidiasis
    Paralytic ileus
    Positive Coombs test
    Renal failure
    Renal impairment
    Urinary tract infections
    Vaginal candidiasis
    Venous thrombosis


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: August 2019

    Reference Sources

    Summary of Product Characteristics: Zerbaxa 1 g/0.5 g powder for concentrate for solution for infusion. Merck Sharp and Dohme Ltd. August 2019.

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Ceftolozane and tazobactam. Last revised: 03 December 2018
    Last accessed: 05 August 2019

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    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

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