Outpatient Utilization of ZERBAXA® (ceftolozane and tazobactam)
Learn about:
- Outpatient utilization
- Stability and dosing
- HCPCS codes for home infusion of ZERBAXA
- Outpatient leave-behind
ZERBAXA®
(ceftolozane and tazobactam) for injection (1.5 g), for intravenous use
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aTotal inpatient health care facilities consisted of hospital inpatient, long-term acute care, and nursing homes.1
Stability and dosing
Drug stability is an important consideration when selecting an antimicrobial for outpatient use2
Upon constitution with sterile water for injection or 0.9% sodium chloride injection, reconstituted solution of ZERBAXA may be held in the vial for 1 hour prior to transfer and dilution of the solution (with 0.9% of sodium chloride or 5% dextrose) in a suitable infusion bag.
Following dilution of the solution with 0.9% sodium chloride or 5% dextrose, ZERBAXA is stable for 24 hours when stored at room temperature or 7 days when stored under refrigeration at 2°C to 8°C (36°F to 46°F). Discard unused portion.
Dosing: ZERBAXA is infused over a 1-hour period
Dosage of ZERBAXA by infection in adult patients (18 years and older) with CrCIa >50 mL/min
Dosage of ZERBAXA in adult patients with renal impairment (CrCla ≤50 mL/min)
aCrCI estimated using Cockcroft-Gault formula; bUsed in conjunction with metronidazole 500 mg intravenously every 8 hours;
Dosage of ZERBAXA by infection in pediatric patients (birth to less than 18 years of age) with eGFRc greater than 50 mL/min/1.73 m2
cEstimated GFR using an age-appropriate equation for use in the pediatric population; dPediatric patients weighing greater than 50 kg should not exceed a maximum dose of 1.5 g.
There is insufficient information to recommend a dosage regimen for pediatric patients with HABP/VABP.
Dosage adjustments in pediatric patients with cUTI or cIAI and with renal impairment
Dosage adjustment of ZERBAXA in pediatric patients (birth to less than 18 years of age) with eGFR of 50 mL/min/1.73 m2 or less has not been determined. ZERBAXA is not recommended in pediatric patients who have an eGFR 50 mL/min/1.73 m2 or less.
cIAI, complicated intra-abdominal infection; CrCl, creatinine clearance; cUTI, complicated urinary tract infection; eGFR, estimated glomerular filtration rate; ESRD, end-stage renal disease; HABP, hospital-acquired bacterial pneumonia; VABP, ventilator-associated bacterial pneumonia.
Download the outpatient leave-behind for guidance on outpatient utilization and dosing information for ZERBAXA.
Questions About Ordering? Contact the Merck National Service Center 1-800-672-6372(1-800-NSC-Merc).
Reference
ZERBAXA is indicated for the treatment of adult patients (18 years and older) with hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP), caused by the following susceptible Gram-negative microorganisms: Enterobacter cloacae, Escherichia coli, Haemophilus influenzae, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, and Serratia marcescens.
ZERBAXA is indicated for the treatment of adult and pediatric patients (birth to less than 18 years old) with complicated urinary tract infections (cUTI), including pyelonephritis, caused by the following susceptible Gram-negative microorganisms: Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa.
ZERBAXA used in combination with metronidazole is indicated for the treatment of adult and pediatric patients (birth to less than 18 years old) with complicated intra-abdominal infections (cIAI) caused by the following susceptible Gram-negative and Gram-positive microorganisms: Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Bacteroides fragilis, Streptococcus anginosus, Streptococcus constellatus, and Streptococcus salivarius.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of ZERBAXA and other antibacterial drugs, ZERBAXA should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Before prescribing ZERBAXA, please read the accompanying Prescribing Information.