What is the recommended dose of ceftolazane/tazobactam (C/T) for adults with normal renal function?

Ceftolozane/Tazobactam Dosing for Adults with Normal Renal Function

The recommended dose of ceftolozane/tazobactam for adults with normal renal function is 1.5 g (1 g ceftolozane/0.5 g tazobactam) administered intravenously every 8 hours. 1

Dosing Recommendations by Indication

Standard Indications

• For complicated urinary tract infections and complicated intra-abdominal infections:
  • 1.5 g (1 g ceftolozane/0.5 g tazobactam) IV every 8 hours 1, 2
  • Administered as a 1-hour intravenous infusion 3
  • Duration: 5-10 days for complicated UTIs and intra-abdominal infections 1

Hospital-Acquired/Ventilator-Associated Pneumonia

• For nosocomial pneumonia (hospital-acquired or ventilator-associated):
  • 3 g (2 g ceftolozane/1 g tazobactam) IV every 8 hours 1, 4
  • Duration: 10-14 days 1

Renal Dosage Adjustments

Ceftolozane/tazobactam requires dose adjustment based on renal function:

Creatinine Clearance (CrCl)	Recommended Dose
>50 mL/min	1.5 g every 8 hours
30-50 mL/min	750 mg every 8 hours
15-29 mL/min	375 mg every 8 hours
ESRD on hemodialysis	Loading dose of 750 mg, then 150 mg every 8 hours [3,5]

Administration Guidelines

• Reconstitute with 10 mL of sterile water or compatible diluent
• Further dilute to 50-150 mL in compatible IV solution
• Administer by IV infusion over 1 hour 6
• For patients on hemodialysis, administer dose after completion of dialysis 3

Clinical Considerations

• Ceftolozane/tazobactam is particularly effective against multidrug-resistant Pseudomonas aeruginosa, including carbapenem-resistant strains 1, 2
• It can be used as a carbapenem-sparing regimen in critically ill patients with healthcare-associated infections 1
• For intra-abdominal infections, combination with metronidazole (500 mg IV every 6 hours) is recommended for anaerobic coverage 1

Pharmacokinetic Considerations

• Linear pharmacokinetics with a plasma half-life of approximately 2.3 hours 2
• Primary elimination is via renal excretion (≥92%) 2
• Low plasma protein binding (approximately 20%) 2

Monitoring

• Regular assessment of renal function is recommended during therapy
• Monitor for adverse effects, particularly in patients with renal impairment
• No routine therapeutic drug monitoring is required for patients with normal renal function

The recommended dosing of ceftolozane/tazobactam is supported by population pharmacokinetic studies demonstrating high probability of target attainment at these doses across various patient populations 4, 7.