C. diff Risk


Oral Bioavailability


Approximate Cost



3.375-4.5g IV q6h

eGFR 0 - 20eGFR 20 - 40eGFR > 402.25g IV q8h

Use q6h dosing for HAP or VAP2.25 g IV q6h

Use 3.375g IV q6h dosing for HAP or VAP3.375 - 4.5 g IV q6h

Pertioneal Dialysis2.25g IV q8h, plus supplemental dose of 0.75g IV after dialysis2.25 g every 12 hours

Use 2.25 g every 8 hours for HAP or VAP

3.375g IV q6h

Depends on type of renal replacement therapy used

Pharmacist consult recommended

General Information

Broad spectrum agent with anti-pseudomonal activity.

Used for severe infections including:

  •  Pneumonia

  •  Intra-abdominal/hepatobiliary

  •  UTI

  •  Polymicrobial skin and soft tissue infection

  •  Febrile neutropenia

Patients on therapy for > 7 days should have (at least) weekly CBC due to risk of drug-induced neutropenia and thrombocytpoenia

  • Allergy/rash (immediate or delayed)

  • Cytopenias- esp. thrombocytopenia

  • Eosinophilia

  • Interstitial nephritis

  • Abnormal liver enzymes

Incr. levels of methotrexate

IV Administration
Dilute in 100 mL D5W or NS and administer over 30-60 min.

EH Prescribing Restrictions

Community IV Formulary (Metro Area)

Antimicrobial class: Ureidopenicillin with a beta-lactamase inhibitor

Pregnancy category: B

Average serum half life: 1 hour

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Poor

Biliary penetration: Therapeutic