Treating infections with ceftolozane/tazobactam in subjects having impaired renal function
Disclosed are methods of administering cephalosporin/tazobactam to human patients with end stage renal disease undergoing hemodialysis and suffering from a complicated intra-abdominal infection or a complicated urinary tract infection.
1. A method of treating pneumonia in a human patient with end stage renal disease on hemodialysis, said method comprising administering to the patient a single loading dose comprising ceftolozane or a pharmaceutically acceptable salt thereof and tazobactam or a pharmaceutically acceptable salt thereof that provides a 2:1 ratio of ceftolozane active to tazobactam active, followed by administering to the patient maintenance doses comprising ceftolozane or a pharmaceutically acceptable salt thereof and tazobactam or a pharmaceutically acceptable salt thereof that provides a 2:1 ratio of ceftolozane active to tazobactam active, wherein the amount of the ceftolozane or pharmaceutically acceptable salt thereof in the loading dose is greater than the amount of the ceftolozane or pharmaceutically acceptable salt thereof in the maintenance doses, and the amount of the tazobactam or pharmaceutically acceptable salt thereof in the loading dose is greater than the amount of the tazobactam or pharmaceutically acceptable salt thereof in the maintenance doses.
2. The method of claim 1 , wherein the maintenance doses are delivered intravenously about every 8 hours.
3. The method of claim 1 , wherein the loading dose and maintenance doses are administered over a dosing schedule that provides an unbound concentration of ceftolozane active of at least 8 micrograms/mL for at least 30% of the time between successive treatment days.
4. The method of claim 3 , wherein the dosing schedule provides an unbound concentration of tazobactam active of at least 1 microgram/mL for at least 20% of the time between successive treatment days.
5. The method of claim 3 , wherein the dosing schedule provides an unbound concentration of tazobactam active of at least 0.5 micrograms/mL for at least 50% of the time between successive treatment days.
6. The method of claim 1 , wherein the loading dose and maintenance doses are administered over a dosing schedule that provides an unbound concentration of ceftolozane active of at least 8 micrograms/mL for at least 40% of the time between successive treatment days.
7. The method of claim 6 , wherein the dosing schedule provides an unbound concentration of tazobactam active of at least 1 microgram/mL for at least 20% of the time between successive treatment days.
8. The method of claim 6 , wherein the dosing schedule provides an unbound concentration of tazobactam active of at least 0.5 micrograms/mL for at least 50% of the time between successive treatment days.
9. The method of claim 3 , wherein the daily AUC of ceftolozane is less than 1,100 μg·hr/mL.
10. The method of claim 1 , wherein the first maintenance dose following completion of hemodialysis is administered to the patient within 3 hours following completion of hemodialysis.
11. The method of claim 1 , wherein the first maintenance dose following completion of hemodialysis is administered to the patient within 2 hours following completion of hemodialysis.
12. The method of claim 1 , wherein the first maintenance dose following completion of hemodialysis is administered to the patient within 1 hour following completion of hemodialysis.
13. The method of claim 1 , wherein the pharmaceutically acceptable salt of ceftolozane is ceftolozane sulfate.
14. The method of claim 1 , wherein the pharmaceutically acceptable salt of tazobactam is tazobactam sodium.
15. A method of treating pneumonia in a human patient with end stage renal disease on hemodialysis, said method comprising administering to the patient a single loading dose comprising ceftolozane or a pharmaceutically acceptable salt thereof and tazobactam or a pharmaceutically acceptable salt thereof that provides a 2:1 ratio of ceftolozane active to tazobactam active, followed by administering to the patient maintenance doses comprising ceftolozane or a pharmaceutically acceptable salt thereof and tazobactam or a pharmaceutically acceptable salt thereof that provides a 2:1 ratio of ceftolozane active to tazobactam active, wherein the ratio of ceftolozane active in the loading dose to ceftolozane active in the maintenance doses is 5:1 by weight, and the ratio of tazobactam active in the loading dose to tazobactam active in the maintenance doses is 5:1 by weight.
16. The method of claim 15 , wherein the maintenance doses are delivered intravenously about every 8 hours.
17. The method of claim 15 , wherein the loading dose and maintenance doses are administered over a dosing schedule that provides an unbound concentration of ceftolozane active of at least 8 micrograms/mL for at least 30% of the time between successive treatment days.
18. The method of claim 17 , wherein the dosing schedule provides an unbound concentration of tazobactam active of at least 1 microgram/mL for at least 20% of the time between successive treatment days.
19. The method of claim 17 , wherein the dosing schedule provides an unbound concentration of tazobactam active of at least 0.5 micrograms/mL for at least 50% of the time between successive treatment days.
20. The method of claim 15 , wherein the loading dose and maintenance doses are administered over a dosing schedule that provides an unbound concentration of ceftolozane active of at least 8 micrograms/mL for at least 40% of the time between successive treatment days.
21. The method of claim 20 , wherein the dosing schedule provides an unbound concentration of tazobactam active of at least 1 microgram/mL for at least 20% of the time between successive treatment days.
22. The method of claim 20 , wherein the dosing schedule provides an unbound concentration of tazobactam active of at least 0.5 micrograms/mL for at least 50% of the time between successive treatment days.
23. The method of claim 17 , wherein the daily AUC of ceftolozane is less than 1,100 μg·hr/mL.
24. The method of claim 15 , wherein the first maintenance dose following completion of hemodialysis is administered to the patient within 3 hours following completion of hemodialysis.
25. The method of claim 15 , wherein the first maintenance dose following completion of hemodialysis is administered to the patient within 2 hours following completion of hemodialysis.
26. The method of claim 15 , wherein the first maintenance dose following completion of hemodialysis is administered to the patient within 1 hour following completion of hemodialysis.
27. The method of claim 15 , wherein the pharmaceutically acceptable salt of ceftolozane is ceftolozane sulfate.
28. The method of claim 15 , wherein the pharmaceutically acceptable salt of tazobactam is tazobactam sodium.
29. The method of claim 1 , wherein the pneumonia is nosocomial pneumonia.
30. The method of claim 1 , wherein the pneumonia is caused by one or more microorganisms selected from the group consisting of Enterobacter cloacae, Escherichia coli, Haemophilus influenzae, Klebsiella oxytoca, Kiebsiella pneumoniae, Proteus Pseudomonas aeruginosa , and Serratia marcescens.
31. The method of claim 30 , wherein the pneumonia is caused by Pseudomonas aeruginosa.
32. The method of claim 15 , wherein the pneumonia is nosocomial pneumonia.
33. The method of claim 15 , wherein the pneumonia is caused by one or more microorganisms selected from the group consisting of Enterobacter cloacae, Escherichia coli, Haemophilus influenzae, Klebsiella oxytoca, Kiebsiella pneumoniae, Proteus mirabilis, Pseudomanas aeruginosa , and Serratia marcescens.
34. The method of claim 33 , wherein the pneumonia is caused by Pseudomonas aeruginosa.