IV Zinforo (Ceftaroline) Dosing for Adults
The usual dose of IV Zinforo (ceftaroline fosamil) for adults is 600 mg administered intravenously every 12 hours, infused over 1 hour. 1
Standard Dosing Regimen
- 600 mg IV every 12 hours is the FDA-approved dose for adults with normal renal function 1
- The infusion should be administered over 1 hour (5-minute to 60-minute infusions produce similar efficacy with different peak concentrations) 1
- No dose adjustment is needed for mild renal impairment (CrCl >50 to ≤80 mL/min) 1
Duration of Therapy by Indication
- Complicated skin and skin structure infections (cSSSI): 5-14 days 2
- Community-acquired pneumonia (CAP): 5-7 days 2
- MRSA skin and soft tissue infections: 600 mg twice daily IV per IDSA guidelines 3
Renal Dose Adjustments
Moderate renal impairment (CrCl >30 to ≤50 mL/min):
- Dosage adjustment is required (specific reduced dose not detailed in provided evidence but adjustment is mandatory) 1
Severe renal impairment (CrCl ≥15 to ≤30 mL/min):
- 400 mg dose produces 115% higher AUC compared to normal renal function; dosage adjustment required 1
End-stage renal disease (ESRD) on hemodialysis:
- Dosage adjustment required; hemodialysis removes approximately 21.6% of the administered dose 1
- Administer after dialysis sessions 1
Pharmacokinetic Considerations
- No accumulation occurs with multiple doses when given every 12 hours for up to 14 days 1
- Protein binding is low (approximately 20%), which contributes to good tissue penetration 1
- Half-life is 2.66 hours with multiple dosing 1
- Renal clearance accounts for 64% of drug elimination, with 88% of radioactivity recovered in urine 1
Important Clinical Considerations
- No hepatic dose adjustment needed as ceftaroline is not a substrate for hepatic CYP450 enzymes 1
- The drug is administered as the prodrug ceftaroline fosamil, which is rapidly converted to active ceftaroline by plasma phosphatases 1
- Time above MIC is the pharmacodynamic parameter that best predicts efficacy 1, 4