Piperacillin/Tazobactam
Antibacterial; β-lactam antibiotic; a fixed combination of piperacillin (extended-spectrum penicillin) and tazobactam (a β-lactamase inhibitor).
Intra-abdominal Infections
Respiratory tract Infections
Septicaemia
Skin and skin structure infections
Empiric therapy in febrile neutropenic patients:
Gynecological and Obstetric Infections:
Urinary Tract Infections
Perioperative prophylaxis
Usually administered by intermittent IV infusion and has been administered by continuous IV infusion†. Do not give by rapid IV injection.
For solution compatibility information, see compatibility under stability.
Do not administer with other drugs (example, in a syringe or infusion bottle)
Do not add to blood products or albumin hydrolysates.
If concomitant use of an aminoglycoside is indicated (for example, treatment of nosocomial pneumonia), reconstitute, dilute, and administer piperacillin/ tazobactam and the aminoglycoside separately.
To be administered by IV infusion for over 3-4 hours† and continuous IV infusion†. Some clinicians suggest 4-hour intermittent IV infusions or continuous IV infusions may be beneficial in certain clinical situations (e.g., critically ill patients, a pathogen with high piperacillin/tazobactam MIC); some evidence that lengthening infusion duration may maximize pharmacokinetic/pharmacodynamic properties of the drug.
Available as fixed combination of piperacillin sodium and tazobactam sodium (piperacillin/tazobactam); the potency of each drug is expressed in terms of the base. Contains 8:1 ratio of piperacillin to tazobactam. The dosage of piperacillin/tazobactam is usually expressed as the total (sum) of the dosage of each of the 2 components (i.e., a dosage of piperacillin plus a dosage of tazobactam). However, dosage for pediatric patients is often expressed in terms of the piperacillin component.
| Prescribing limits | |
|---|---|
| Pediatric patients | Maximum 16 g (of piperacillin) daily; AAP states a maximum of 24 g (of piperacillin) daily may be appropriate in some cystic fibrosis patients. |
| Adults | 4.5 g (4 g of piperacillin and 0.5 g of tazobactam) every 6 hours. Maximum 18 g (16 g of piperacillin and 2 g of tazobactam) daily recommended by manufacturer. |
| Renal impairment |
Adjust dosage in adults with Clcr ≤40 mL/minute, including those undergoing hemodialysis or CAPD. (See Table 3.)
Dosage recommendations are not available for pediatric patients with renal impairment.
Hemodialysis removes approximately 30-40% of piperacillin/tazobactam; supplemental dose of the drug needed after each hemodialysis session. Supplemental doses of piperacillin/tazobactam not needed in CAPD patients |
| Geriatric patients | Select dosage with caution, usually starting at low end of dosage range, because of age-related decreases in hepatic, renal, and/or cardiac function. (see Geriatric Use under Cautions.) |
| Clcr (mL/min) | Daily Dosage (Except Nosocomial Pneumonia) | Overall dosage |
|---|---|---|
| 20 - 40 | 2.25 g every 6 hours | 3.375 g every 6 hours |
| <20 | 2.25 g every 8 hours | 2.25 g every 6 hours |
| Hemodialysis Patients | 2.25 g every 12 hours; also give 0.75 g after each hemodialysis session | 2.25 g every 8 hours; also give 0.75 g after each hemodialysis session |
| CAPD Patients | 2.25 g every 12 hours | 2.25 g every 8 hours |
Hypersensitivity to any penicillin, cephalosporin, or β-lactamase inhibitor