Piperacillin and Tazobactam

Broad-spectrum Penicillin · Beta-lactamase inhibitor/Broad-spectrum penicillin

Indications

Intra-abdominal infections, nosocomial pneumonia, skin and skin structure infection, female pelvic infections, community-acquired pneumonia.

Dosage

IV: Adults: Indications other than Nosocomial Pneumonia: 3.375 gms every 6 hrs, totaling 13.5 gms daily (12 gms piperacillin and 1.5 gms tazobactam) for 7-10 days. Nosocomial Pneumonia: 4.5 gms every 6 hrs plus an aminoglycoside, totaling 18 gms (16 gms piperacillin and 2 gms tazobactam) for 7-14 days. Children: Appendicitis and/or Peritonitis: =2-9 months: 90 mg/kg (80 mg piperacillin and 10 mg tazobactam) every 8 hrs. >9 months: 112.5 mg/kg (100 mg piperacillin and 12.5 mg tazobactam) every 8 hrs. <2 months: Not recommended. Nosocomial Pneumonia: =2-9 months: 90 mg/kg (80 mg piperacillin and 10 mg tazobactam) every 6 hrs. >9 months: 112.5 mg/kg (100 mg piperacillin and 12.5 mg tazobactam) every 6 hrs. <2 months: Not recommended.

Administration

IV: Administer by IV infusion over 30 min. Reconstitution: Use single-dose vials immediately after reconstitution (discard unused portions after 24 hours at room temperature and 48 hours if refrigerated). Reconstitute with 5 mL of diluent per 1 gm of piperacillin and then further dilute. Compatible diluent include NS, SWFI, dextran 6%, D5W, D5W with potassium chloride 40 mEq, bacteriostatic saline and water. Compatibility: Stable in dextran 6% in NS, D5W, NS, SWFI, bacteriostatic water. Incompatible with LR. Y-site administration: Drug to Drug IV Compatibility: Amikacin, aztreonam, bumetanide, calcium gluconate, cefepime, cimetidine, cisatracurium, dexamethasone, diphenhydramine, dopamine, enalapril, epinephrine, esmolol, fentanyl, fluconazole, furosemide, heparin, hydrocortisone, hydromorphone, lansoprazole, linezolid, lorazepam, magnesium sulphate, methylprednisolone, metoclopramide,…

Adverse Effects

Diarrheoa, constipation, headache, insomnia, nausea, fever, oral candidiasis, rash, vomiting, dyspepsia, pruritus, pain, hypertension, leucopaenia, thrombocytopaenia.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Hypersensitivity to penicillins, cephalosporins or other beta-Iactams. Precautions: Renal failure. Patients with low K+ reserves. Neutropenia, leucopenia. Monitor blood counts, electrolytes, renal and hepatic function during prolonged treatment. Sodium restricted diets.

Interactions

Probenecid, drugs affecting blood Coagulation and/or thrombocyte function, non-depolarising muscle relaxants, methotrexate, vancomycin, aminoglycosides.

Advice to Patient

This medication is to be administered by injection or infusion only. Contact prescriber if there is burning/swelling/redness/pain at infusion site or if there is chest tightness, chest pain, difficulty in breathing or swallowing, palpitations, irregular heartbeat, hives, rash, swelling of mouth or lips, white patches on tongue or in mouth, severe persistent diarrhoea, acute or persistent headache, confusion, hallucinations, agitations, seizures, constant abdominal pain, cramps, diarrhoea, unusual fever. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber.

Pharmacokinetics

Both AUC and peak concentrations are dose proportional. Metabolism: Piperacillin: 6%-9%. Tazobactam: Approx. 22%. Bioavailability: IM: Piperacillin: 71%. Tazobactam: 84%. Half-life elimination: Piperacillin: Infants 2-5 mth: 1.4 hrs. Infants and Children 6-23 mth: 0.9 hr. Children 2-12 yrs: 0.7 hr. Adults: 0.7-1.2 hrs. Metabolite: 1-1.5 hrs. Tazobactam: Infants 2-5 mth: 1.6 hrs. Infants and Children 6-23 mth: 1 hr. Children 2-12 yrs: 0.8-0.9 hr. Adults: 0.7-0.9 hr. Time to peak, plasma: Immediately following completion of 30-min infusion. Excretion: Piperacillin: Urine (68%). Faeces (10%-20%). Tazobactam: Urine (80%).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.