II. Indications
- Complicated Intraabdominal Infections (e.g. Appendicitis, peritonitis, Diverticulitis with abscess)
- Complicated genitourinary infections (e.g. Postpartum Endometritis, Pelvic Inflammatory Disease)
- Nosocomial Pneumonia
- Sepsis
III. Mechanism
- Fourth generation, Extended Spectrum Penicillin (acylamino-Penicillin)
- Added activity to Natural Penicillins
- High affinity for Penicillin binding Proteins
- Greater penetration through Gram Negative membrane
- Activity against Pseudomonas
- Beta lactamase resistance with Tazobactam
- Activity Spectrum
- Similar to Natural Penicillins and Aminopenicillins
- Expanded Gram Negative coverage
IV. Dosing
- Adult (or child weight >40 kg)
- Give 3.375 to 4.5 g IV every 6 hours
- Child (weight <40 kg)
- Dosing is based on Piperacillin component
- Age 2 to 6 months
- Give 80 mg/kg IV every 8 hours OR
- Give 150 to 300 mg/kg/day IV divided every 6 to 8 hours
- Age >6 months
- Give 100 mg/kg IV every 8 hours OR
- Give 300 to 400 mg/kg/day IV divided every 6 to 8 hours
-
Renal Dosing (Adults)
- eGFR 20 to 40 ml/min
- Give 2.25 g IV every 6 hours
- eGFR <20 ml/min
- Give 2.25 g IV every 12 hours AND
- Give 0.75 g IV after each Hemodialysis run
- eGFR 20 to 40 ml/min
V. Adverse Effects
- Platelet Dysfunction
-
Renal Failure
- Higher risk in Critical Illness
- Increased risk when combined with Vancomycin
VI. Safety
- Pregnancy Category B
- Unknown safety in Lactation
VII. Drug Interactions
-
Nondepolarizing Neuromuscular Blocking Agent
- Prolonged Neuromuscular Blockade
-
Methotrexate
- Decreased renal excretion (higher Methotrexate levels, toxicity risk)
VIII. Resources
- Piperacillin Tazobactam (DailyMed)
IX. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Miller (2002) J Midwifery Womens Health 47(6):426-34 +PMID: 12484664 [PubMed]
- Bush (2016) Cold Spring Harb Perspect Med 6(8):a025247 +PMID: 27329032 [PubMed]
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Related Studies
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 |