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Clinical context remains essential
Independent clinical review is pending. Confirm indication, exact formulation/route, population, renal measure and units, kidney-function stability, dialysis prescription, interacting drugs, monitoring and source revision. An RX mirror and its original label are not independent corroboration. Missing disagreement notes do not certify agreement.
Record caution: Label-version change: the May 2026 DailyMed pediatric renal table is now local. Older pediatric evidence-gap statements remain historical; read the new age-specific source before selecting a regimen.
U.S. labeling, UCSF and Nebraska distinguish indication and infusion duration. Nebraska uses a 4-hour inpatient infusion; the label uses 1 hour. Keep each renal table with its indication and infusion method.
Check source scope before reading a dose
ZERBAXA - May 2026 pediatric renal regimens
Product / population
Pediatric ZERBAXA age 2 to below 18 with renal impairment; May 2026 label, Table 4. Doses are total ceftolozane+tazobactam.
Renal method
Validated pediatric eGFR, mL/min/1.73 m2; not adult Cockcroft-Gault.
Source revision
May 2026
Retrieved
2026-09-07
Local review status
Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.
Documented differences and cautions on this drug
All record notes are retained here, including notes about sources not selected in this review.
One-hour labeling versus institutional extended infusion
The RX label table uses a one-hour infusion. The UCSF protocol uses a three-hour infusion. Both also separate urinary/intra-abdominal infection from pneumonia/severe infection.
What to reconcile: Keep the selected source dose, indication, renal band, loading instruction and infusion duration together.
Source difference identified; final patient-specific adjudication required.
Pediatric renal guidance changed after the RX mirror
The older mirror lacks the age-specific renal regimens now supplied by the May 2026 label.
What to reconcile: Use the new pediatric card for ages two and older; verify indication, pediatric eGFR, weight caps and infusion time. Do not use adult Cockcroft-Gault bands as pediatric instructions.
DailyMed / Merck Sharp & Dohme LLC · Pediatric ZERBAXA age 2 to below 18 with renal impairment; May 2026 label, Table 4. Doses are total ceftolozane+tazobactam.
Renal method: Validated pediatric eGFR, mL/min/1.73 m2; not adult Cockcroft-Gault. Source date: May 2026 Retrieved: 2026-09-07
Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.
Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.
Renal dosing, restrictions and evidence limits
Age 2 to below 18 years: use a validated pediatric eGFR equation (mL/min/1.73 m2). For cIAI/cUTI, total combination mg/kg every eight hours at eGFR 51 to below 90, 30-50 and 15-29 are respectively 30, 15 and 7.5; infuse over one hour. For HABP/VABP, corresponding doses are 75, 37.5 and 18.75 mg/kg every eight hours over two hours. Intermittent HD: cIAI/cUTI loads 15 mg/kg then 3 mg/kg every eight hours; pneumonia loads 45 mg/kg then 9 mg/kg every eight hours. Give post-HD doses as early as possible after dialysis. Above 50 kg for cIAI/cUTI or 40 kg for pneumonia, do not exceed the adult renal dose. Below eGFR 15 without HD, dosing is not established. Renal-impairment dosing is not recommended below age two. Reassess changing eGFR daily. cIAI also requires metronidazole. These 2026 regimens supersede the older mirror's broad pediatric renal evidence gap.
RDM37-official-ceftolozane-tazobactam-3c655e39ee-C1 · Source locator: Sections 2.4 and 8.6, Table 4, including weight caps and dialysis footnotes.
This reference does not select a regimen. Complete the indication, measured/estimated renal function and trend, dialysis setting, source rationale, monitoring and reassessment plan in your institution's approved documentation system. Confirm the complete current source before adopting its regimen.
GlobalRPh v6.6 | RDM66-DIRECT-PHP-20260911 | Local library date 2026-09-11. Selected-card identity does not imply clinical verification.