II. Indications

  1. Complicated Intraabdominal Infections (e.g. Appendicitis, peritonitis, Diverticulitis with abscess)
  2. Complicated genitourinary infections (e.g. Postpartum Endometritis, Pelvic Inflammatory Disease)
  3. Nosocomial Pneumonia
  4. Sepsis

III. Mechanism

  1. Fourth generation, Extended Spectrum Penicillin (acylamino-Penicillin)
  2. Added activity to Natural Penicillins
    1. High affinity for Penicillin binding Proteins
    2. Greater penetration through Gram Negative membrane
    3. Activity against Pseudomonas
    4. Beta lactamase resistance with Tazobactam
  3. Activity Spectrum
    1. Similar to Natural Penicillins and Aminopenicillins
    2. Expanded Gram Negative coverage
      1. Escherichia coli
      2. Morganella
      3. Proteus
      4. Providencia
      5. Salmonella
      6. Shigella
      7. Pseudomonas

IV. Dosing

  1. Adult (or child weight >40 kg)
    1. Give 3.375 to 4.5 g IV every 6 hours
  2. Child (weight <40 kg)
    1. Dosing is based on Piperacillin component
    2. Age 2 to 6 months
      1. Give 80 mg/kg IV every 8 hours OR
      2. Give 150 to 300 mg/kg/day IV divided every 6 to 8 hours
    3. Age >6 months
      1. Give 100 mg/kg IV every 8 hours OR
      2. Give 300 to 400 mg/kg/day IV divided every 6 to 8 hours
  3. Renal Dosing (Adults)
    1. eGFR 20 to 40 ml/min
      1. Give 2.25 g IV every 6 hours
    2. eGFR <20 ml/min
      1. Give 2.25 g IV every 12 hours AND
      2. Give 0.75 g IV after each Hemodialysis run

V. Adverse Effects

  1. Platelet Dysfunction
  2. Renal Failure
    1. Higher risk in Critical Illness
    2. Increased risk when combined with Vancomycin

VI. Safety

  1. Pregnancy Category B
  2. Unknown safety in Lactation

VII. Drug Interactions

  1. Nondepolarizing Neuromuscular Blocking Agent
    1. Prolonged Neuromuscular Blockade
  2. Methotrexate
    1. Decreased renal excretion (higher Methotrexate levels, toxicity risk)

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Ontology: piperacillin-tazobactam combination (C0250480)

Definition (NCI_NCI-GLOSS) A drug combination that is used to treat infection in people with cancer. Piperacillin is a synthetic penicillin; tazobactam enhances the effectiveness of piperacillin.
Definition (NCI) A combination formulation of the antibiotic piperacillin and the beta-lactamase inhibitor tazobactam with antibacterial activity. Piperacillin, a broad-spectrum, semisynthetic penicillin, binds to and inactivates penicillin-binding proteins (PBP) located on the inner membrane of the bacterial cell wall, thereby interfering with the cross-linking of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. As a result, the cell wall is weakened and the cell lyses. Tazobactam, a penicillanic acid sulfone derivative, irreversibly binds to and inhibits bacterial beta-lactamase at or near its active site, thereby preventing the destruction of the beta-lactamase susceptible piperacillin by this bacterial enzyme.
Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH C085143
SnomedCT 346628003, 96074000, 387547002, 703743007
LNC LP16311-0, MTHU008472
English PIPERACILLIN/TAZOBACTAM, Piperacillin sodium/tazobactam sodium injection solution vial, piperacillin-tazobactam combination, Piperacillin + Tazobactam, piperacillin-tazobactam, Piperacillin / tazobactam, tazobactam piperacillin, piperacillin tazobactam, Piperacillin with tazobactam (product), Piperacillin with tazobactam (substance), Piperacillin+Tazobactam, Piperacillin + tazobactam, Piperacillin + tazobactam (substance), Piperacillin+tazobactam, Piperacillin with tazobactam, Piperacillin+tazobactam (product), PIPER-TAZO, Piperacillin+tazobactam (substance), PIPER/TAZO, Piperacillin-Tazobactam, Piperacillin/Tazobactam, piperacillin-tazobactam combination product, Piperacillin and Tazobactam
Spanish piperacilina con tazobactam (producto), piperacilina con tazobactam (sustancia), piperacilina con tazobactam, piperacilina+tazobactam (producto), piperacilina+tazobactam

Ontology: Zosyn (C0250482)

Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH C085143
English Zosyn, tazocin, zosyn, Tazocin, Tazocel, Wyeth brand of pipercillin sodium - tazobactam sodium, AHP brand of pipercillin sodium - tazobactam sodium