Piperacillin and Tazobactam
(pi per' a sil in) (ta zoe bak' tam)
P : Caution when used during pregnancy
L : Caution when used during lactation
|| See TERMINOLOGY & ABBREVIATIONS ||
|Indication(s) & Dosage||Intravenous route
Adult: Initial dose: 4.5 g (piperacillin 4 g and tazobactam 0.5 g) every 6 hr for 7-14 days. When used empirically, combination with an aminoglycoside or antipseudomonal fluoroquinolone is recommended. May be given via infusion over 30 minutes. If Pseudomonas aeruginosa is not isolated, may discontinue aminoglycoside.
Child: 2-8 mth: 80 mg of piperacillin/kg every 8 hr; â‰¥9 mth and â‰¤40 kg: 100 mg of piperacillin/kg every 8 hr.
Renal impairment: For haemodialysis: admin an additional dose of 0.75 g after each dialysis session on hemodialysis days.
Adult: 3.375 g (piperacillin 3 g and tazobactam 0.375 g) every 6 hr for 7-10 days. May be given via infusion over 30 minutes.
Renal impairment: For haemodialysis, admin an additional dose of 0.75 g after each dialysis session on haemodialysis days.
Incompatibility: Not compatible with tobramycin for simultaneous admin via Y-site infusion.
|Special Precautions||Pregnancy and lactation, pseudomembranous colitis. Assess hematopoietic function periodically. Perform periodic electrolyte determinations in patients with low K reserves. Increased risk of fever and rash in patients with cystic fibrosis. Increased risk of bleeding manifestations. Prolonged treatment may increase risk of superinfections. Convulsions or neuromuscular excitability may occur when high doses are used, especially in renally impaired patients. Renal impairment.|
|Adverse Drug Reaction(s)||Diarrhoea, skin rashes, occasionally platelet mediated bleeding, rigors, malaise, ulcerative stomatitis.
Inj-site reactions such as pain, erythema, induration and thrombophlebitis.
Potentially Fatal: Serious, anaphylactic reactions.
|Drug Interactions||Probenecid prolongs half lives of piperacillin and tazobactam. Increased risk of
methotrexate toxicity when used together.
Potentially Fatal: Interacts with heparin and other oral anticoagulants. Prolongs the neuromuscular blockade of vecuronium and non-depolarizing muscle relaxants. Please consult detailed drug interactions before prescribing.
|Pregnancy Category (FDA)||Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).|
|Storage||Intravenous: Inj vials should be stored at 20-25Â°C prior to reconstitution.|
|Pharmacology||Piperacillin has an antimicrobial activity against a wide range of gm-ve organisms including K.
pneumoniae, P. aeruginosa, Enterobacteriaceae and against gm+ve organisms eg E.
faecalis and B. fragilis. Tazobactam is a penicillanic acid sulfone derivative with beta-lactamase inhibitory properties. In
combination, tazobactam enhances the activity of piperacillin against beta-lactamase-producing bacteria.
Distribution: Piperacillin and tazabactam: 30% bound to plasma proteins. Widely distributed into body tissues and fluids.
Metabolism: Piperacillin: metabolised to a desethyl metabolite. Tazobactam: metabolised to a single metabolite that lacks pharmacological and antibacterial activities.
Excretion: Half-life of piperacillin and tazobactam ranges from 0.7-1.2 hr. Eliminated via kidney by glomerular filtration and tubular secretion. Piperacillin: 68% excreted unchanged in urine.Tazobactam: 80% excreted unchanged in urine.
|ATC Classification||J01CG02 - tazobactam; Belongs to the class of beta-lactamase
inhibitors. Used in the treatment of systemic infections.
J01CA12 - piperacillin; Belongs to the class of penicillins with extended spectrum. Used in the treatment of systemic infections.
|Brand Name||Manufacturer/Marketer||Composition||Dosage Form||Pack Size & Price|
|MEGACILIN||Popular Pharmaceuticals Ltd.||PIPERACILLIN + TAZOBACTAM||IV Infusion||4.5gm (combipack): 1003.78 MRP|
|TAZOCILIN 4.5||Square Pharmaceuticals Ltd.||Piperacillin 4gm + Tazobactam 0.5 gm||IV Infusion||1x1's: 1003.01 MRP|
Why is this medication prescribed?
Piperacillin and tazobactam, an antibiotic, helps treat infection. The drug will be added to an intravenous fluid that will drip through a needle or catheter placed in vein for 30 minutes, three or four times a day.
The combination of piperacillin and tazobactam eliminates bacteria that cause many kinds of infections, including pneumonia and skin, stomach, and gynecological infections. This medication is sometimes prescribed for other uses; ask your doctor for more information.
Your health care provider may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how your infection and symptoms respond to the medication.
Before administering piperacillin and tazobactam,
- tell your doctor if you are allergic to piperacillin, penicillin, cephalosporins [e.g., cefaclor, cefadroxil, or cephalexin], or any other drugs.
- tell your doctor what prescription and nonprescription medications you are taking, especially antibiotics and vitamins.
- tell your doctor if you have or have ever had asthma; hay fever; or kidney, liver or gastrointestinal disease (especially colitis).
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking piperacillin and tazobactam, call your doctor.
Administering your medication
Before you administer piperacillin and tazobactam, look at the solution closely. It should be clear and free of floating material. Gently squeeze the bag or observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or container leaks. Use a new solution, but show the damaged one to your health care provider.
It is important that you use your medication exactly as directed. Do not stop your therapy on your own for any reason because your infection could worsen and result in hospitalization. Do not change your dosing schedule without talking to your health care provider. Your health care provider may tell you to stop your infusion if you have a mechanical problem (such as a blockage in the tubing, needle, or catheter); if you have to stop an infusion, call your health care provider immediately so your therapy can continue.
Piperacillin and tazobactam may cause side effects. Tell your health care provider if any of these symptoms are severe or do not go away:
unpleasant or abnormal taste
If you experience any of the following symptoms, call your health care provider immediately:
shortness of breath
- unusual bruising or bleeding
Storing your medication
Your health care provider probably will give you a several-day supply of piperacillin and tazobactam at a time. You will be told to store it in the refrigerator.
Take your next dose from the refrigerator 1 hour before using it; place it in a clean, dry area to allow it to warm to room temperature.
Store your medication only as directed. Make sure you understand what you need to store your medication properly.
Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury.
In case of emergency/overdose
In case of overdose, consult your doctor. If the victim has collapsed or is not breathing, consult local medical emergency services.
Signs of infection
If you are receiving piperacillin and tazobactam in your vein or under your skin, you need to know the symptoms of a catheter-related infection (an infection where the needle enters your vein or skin). If you experience any of these effects near your intravenous catheter, tell your health care provider as soon as possible:
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to this medicine.
Do not let anyone else use your medication. If you still have symptoms and need further treatment, consult your doctor.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Ref: U.S. National Library of Medicine.
This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.