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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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 |