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Piperacillin sodium and Tazobactam sodium
Piperacillin sodium and Tazobactam sodium
Piperacillin sodium and Tazobactam sodium
(pie-PER-ah-sill-in, tay-zoh-BAC-tam)
Pregnancy Category: B Tazocin Zosyn (Rx)

Classification: Antibiotic, penicillin

See Also: See also Piperacillin sodium and Penicillins.

Action/Kinetics: A combination of piperacillin sodium and tazobactam sodium, a beta-lactamase inhibitor. Tazobactam inhibits beta-lactamases, thus ensuring activity of piperacillin against beta-lactamase-producing microorganisms. Thus, tazobactam broadens the antibiotic spectrum of piperacillin to those bacteria normally resistant to it. Peak plasma levels: Attained immediately after completion of an IV infusion. t1/2, piperacillin and tazobactam: 0.7-1.2 hr. Both drugs are eliminated through the kidney with piperacillin excreted unchanged and tazobactam excreted both unchanged and as inactive metabolites. The t1/2 of both drugs is increased in clients with renal impairment and in hepatic cirrhosis (dose adjustment not required).

Uses: (1) Appendicitis complicated by rupture or abscess and peritonitis caused by piperacillin-resistant, beta-lactamase-producing strains of Escherichia coli, Bacteroides fragilis, B. ovatus, B. thetaiotaomicron or B. vulgatus. (2) Uncomplicated and complicated skin and skin structure infections (including cellulitis, cutaneous abscesses, and ischemic/diabetic foot infections) caused by piperacillin-resistant, beta-lactamase-producing strains of Staphylococcus aureus. (3) Postpartum endometritis or PID caused by piperacillin-resistant, beta-lactamase-producing strains of E. coli. (4) Community-acquired pneumonia of moderate severity caused by piperacillin-resistant, beta-lactamase-producing strains of Haemophilus influenzae. (5) Moderate to severe nosocomial pneumonia caused by piperacillin-resistant, beta-lactamase-producing strains of S. aureus. (6) Infections caused by piperacillin-susceptible organisms for which piperacillin is effective may also be treated with this combination. The treatment of mixed infections caused by piperacillin-susceptible organisms and piperacillin-resistant, beta-lactamase-producing organisms susceptible to this combination does not require addition of another antibiotic.

Contraindications: Hypersensitivity to penicillins, cephalosporins, or beta-lactamase inhibitors.

Special Concerns: Use with caution during lactation. Safety and efficacy have not been determined in children less than 12 years of age.

Side Effects: See Penicillins(/italic>. The highest incidence of side effects include the following. GI: Diarrhea, constipation, N&V;, dyspepsia, stool changes, abdominal pain. CNS: Headache, insomnia, fever, agitation, dizziness, anxiety. Dermatologic: Rash, including maculopapular, bullous, urticarial, and eczematoid; pruritus. Hematologic: Thrombocytopenia, eosinophilia, leukopenia, neutropenia. Miscellaneous: Pain, moniliasis, hypertension, chest pain, edema, rhinitis, dyspnea.

Laboratory Test Alterations: H&H.; Transient AST, ALT, alkaline phosphatase, and bilirubin. Serum creatinine, BUN. Prolonged PT and PTT. Positive direct Coombs' test. Proteinuria, hematuria, pyuria, abnormalities in electrolytes ( and sodium, potassium, calcium), hyperglycemia, total protein or albumin.

Drug Interactions: Heparin / Possible heparin effect Oral anticoagulants / Possible anticoagulant effect Tobramycin / Area under the curve, renal clearance, and urinary recovery of tobramycin Vecuronium / Prolongation of neuromuscular blockade

How Supplied: Injection: 40 mg-5 mg/mL, 60 mg-7.5 mg/mL, 4 g-0.5 g/100 mL; Powder for Injection: 2 g-0.25 g, 3 g-0.375 g, 4 g-0.5 g, 36 g-4.5g

Dosage
•IV Infusion Susceptible infections.
Adults: 12 g/day piperacillin and 1.5 g/day tazobactam, given as 3.375 g (i.e., 3 g piperacillin and 0.375 g tazobactam) q 6 hr for 7-10 days. In clients with renal insufficiency, the IV dose is adjusted depending on the extent of impaired function. If C_CR is 20-40 mL/min, the dose is 8 g/day piperacillin and 1 g/day tazobactam in divided doses of 2.25 g q 6 hr. If the C_CR is less than 20 mL/min, the dose is 6 g/day piperacillin and 0.75 g/day tazobactam in divided doses of 2.25 g q 8 hr.
Moderate to severe nosocomial pneumonia due to piperacillin-resistant, beta-lactamase-producing S. aureus.
Adults: 3.375 g q 4 hr with an aminoglycoside for 7 to 14 days.