Formulary
Piperacillin with tazobactam: Indications, Dosing, Side Effects and Interactions
The penicillins are bactericidal and act by interfering with bacterial cell wall synthesis.
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Piperacillin with tazobactam: Indications, Dosing, Side Effects and Interactions
The penicillins are bactericidal and act by interfering with bacterial cell wall synthesis.
Drug action
The penicillins are bactericidal and act by interfering with bacterial cell wall synthesis. They diffuse well into body tissues and fluids, but penetration into the cerebrospinal fluid is poor except when the meninges are inflamed. They are excreted in the urine in therapeutic concentrations.
Indications and dose
**Hospital-acquired pneumonia,Septicaemia,Complicated infections involving the urinary-tract,Complicated infections involving the skin,Complicated infections involving the soft-tissues,Acute exacerbation of chronic obstructive pulmonary disease,Acute exacerbation of bronchiectasis,Moderate diabetic foot infection,Severe diabetic foot infection,Leg ulcer infection**
- **Adult** (By Intravenous Infusion): 4.5 g every 8 hours; increased if necessary to 4.5 g every 6 hours, increased frequency may be used for severe infections.
**Infections in neutropenic patients**
- **Adult** (By Intravenous Infusion): 4.5 g every 6 hours.
**Hospital-acquired pneumonia, Septicaemia, Complicated infections involving the urinary-tract, Complicated infections involving the skin, Complicated infections involving the soft-tissues for piperacillin with tazobactam**
- **Neonate** (By intravenous infusion): 90 mg/kg every 8 hours.
- **Child 1 month-11 years** (By intravenous infusion): 90 mg/kg every 6-8 hours (max. per dose 4.5 g).
- **Child 12-17 years** (By intravenous infusion): 4.5 g every 8 hours; increased if necessary to 4.5 g every 6 hours, increased frequency may be used for severe infections.
**Complicated intra-abdominal infections for piperacillin with tazobactam**
- **Child 2-11 years** (By intravenous infusion): 112.5 mg/kg every 8 hours (max. per dose 4.5 g).
- **Child 12-17 years** (By intravenous infusion): 4.5 g every 8 hours; increased if necessary to 4.5 g every 6 hours, increased frequency may be used for severe infections.
**Acute exacerbation of bronchiectasis for piperacillin with tazobactam**
- **Child 1 month-11 years** (By intravenous infusion): 90 mg/kg every 6-8 hours (max. per dose 4.5 g).
- **Child 12-17 years** (By intravenous infusion): 4.5 g every 8 hours; increased if necessary to 4.5 g every 6 hours, increased frequency may be used for severe infections.
**Infections in neutropenic patients for piperacillin with tazobactam**
- **Child** (By intravenous infusion): 90 mg/kg every 6 hours (max. per dose 4.5 g).
Cautions
History of allergy Cautions For piperacillin with tazobactam High doses may lead to hypernatraemia (owing to sodium content of preparations)
Side effects
Common or very common Diarrhoea; hypersensitivity; nausea; skin reactions; thrombocytopenia; vomiting Uncommon Arthralgia; leucopenia Rare or very rare Agranulocytosis; angioedema; haemolytic anaemia; hepatic disorders; nephritis tubulointerstitial; neutropenia; pseudomembranous enterocolitis; seizure; severe cutaneous adverse reactions (SCARs) Side-effects, further information Diarrhoea frequently occurs during oral penicillin therapy. It is most common with broad-spectrum penicillins, which can cause antibiotic-associated colitis. Side-effects For piperacillin with tazobactam Common or very common Anaemia; candida infection; constipation; gastrointestinal discomfort; headache; insomnia Uncommon Flushing; hypokalaemia; hypotension; myalgia; thrombophlebitis Rare or very rare Epistaxis; stomatitis Frequency not known Eosinophilia; pancytopenia; pneumonia eosinophilic; renal failure; thrombocytosis
Pregnancy
For piperacillin with tazobactam Manufacturers advise use only if potential benefit outweighs risk.
Breast feeding
For piperacillin with tazobactam Trace amount in milk, but appropriate to use.
Renal impairment
For piperacillin with tazobactam Dose adjustments See Prescribing in renal impairment . Max. 4.5 g every 8 hours if creatinine clearance 20-40 mL/minute. M Max. 4.5 g every 12 hours if creatinine clearance less than 20 mL/minute. M
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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