Trade Names:Zosyn- Injection, powder for solution piperacillin 2 g and tazobactam 0.25 g- Injection, powder for solution piperacillin 3 g and tazobactam 0.375 g- Injection, powder for solution piperacillin 4 g and tazobactam 0.5 g- Injection, powder for solution piperacillin 36 g and tazobactam 4.5 g (bulk)- Injection, solution piperacillin 2 g and tazobactam 0.25 g- Injection, solution piperacillin 3 g and tazobactam 0.375 g- Injection, solution piperacillin 4 g and tazobactam 0.5 gTazocin (Canada)
Inhibits bacterial cell wall mucopeptide synthesis.
Treatment of moderate to severe infections caused by piperacillin-resistant, piperacillin/tazobactam–susceptible, beta-lactamase–producing strains of microorganisms in the following conditions: appendicitis (complicated by rupture or abscess), uncomplicated and complicated skin and skin structure infections, peritonitis, postpartum endometritis or pelvic inflammatory disease, community-acquired pneumonia (moderate severity only), nosocomial pneumonia (moderate to severe).
History of allergic reactions to penicillins, cephalosporins, or beta-lactamase inhibitors; hypersensitivity to any component of the product.
Administer by IV infusion over 30 min.Nosocomial PneumoniaAdults
IV Start with 4.5 g every 6 h plus an aminoglycoside (administered separately) for 7 to 14 days.Healthy Renal Function (CrCl 90 mL/min or more)Adults
IV 3.375 g every 6 h, totaling 13.5 g (piperacillin 12 g/tazobactam 1.5 g), for 7 to 10 days.Children 2 mo of age and older
IV Piperacillin 80 mg/tazobactam 10 mg per kg every 8 h. Children weighing more than 40 kg with healthy renal function should receive the adult dose.Children 2 mo of age and older with appendicitis and/or peritonitis
IV Children between 2 and 9 mo of age – piperacillin 80 mg/tazobactam 10 mg per kg every 8 h. Children 9 mo of age and older weighing up to 40 kg – piperacillin 100 mg/tazobactam 12.5 mg per kg every 8 h. Children weighing more than 40 kg – Administer the adult dose.Renal Function ImpairmentAdults CrCl more than 40 mL/min
IV 4.5 g every 6 h (nosocomial pneumonia). 3.375 g every 6 h (other indications).CrCl 20 to 40 mL/min
IV 3.375 g every 6 h (nosocomial pneumonia). 2.25 g every 6 h (other indications).CrCl less than 20 mL/min
IV 2.25 g every 6 h (nosocomial pneumonia). 2.25 g every 8 h (other indications).
There are no dosage recommendations for children with renal function impairment.HemodialysisAdults
IV Max dosage is 2.25 g every 8 h for nosocomial pneumonia and every 12 h for other indications, plus 1 additional dose of 0.75 g following each dialysis period.Continuous Ambulatory Peritoneal Dialysis (CAPD)Adults
IV 2.25 g every 8 h for nosocomial pneumonia and every 12 h for other indications.Elderly
Start at the low end of the dose range.
May form microbiologically inactive complexes; do not mix in the same container.Anticoagulants/Heparin
Frequently monitor coagulation parameters.Methotrexate
May reduce Cl of methotrexate.Probenecid
Increases and prolongs half-life of penicillin levels.Vecuronium
Neuromuscular blockade may be prolonged.
Ringer's lactate solution.
False-positive reaction for glucose in the urine using a copper-reduction method (eg, Clinitest ) but not with enzyme-based tests (eg, Diastix , Tes-Tape ). False-positive results for Aspergillus have been reported using the Bio-Rad Laboratories' Platelia Aspergillus EIA test.
The incidences stated for the following adverse reactions were reported with piperacillin/tazobactam administration alone. Adverse reactions occurring with administration of piperacillin/tazobactam in combination with other antibiotics (eg, an aminoglycoside) are not included. Adverse reactions occurring in children are similar to those reported in adults.
Headache (8%); insomnia (7%); agitation (2%); anxiety, dizziness (1%).
Rash, including bullous, eczematoid, maculopapular, and urticarial (4%); pruritus (3%); erythema multiforme, Stevens-Johnson syndrome, TEN (postmarketing).
Diarrhea (11%); constipation (8%); nausea (7%); dyspepsia, vomiting (3%); stool changes (2%); abdominal pain (1%).
Interstitial nephritis, renal failure (postmarketing).
Agranulocytosis, anemia, hemolytic anemia, pancytopenia, thrombocytosis (postmarketing).
Cholestatic jaundice, hepatitis (postmarketing).
Anaphylactic/anaphylactoid reactions (including shock), hypersensitivity reactions (postmarketing).
Fever, moniliasis, pain (2%); chest pain, edema (1%); candidal superinfections (postmarketing).
Periodically assess hematopoietic function, especially with prolonged therapy (ie, 21 days or more). Perform periodic electrolyte determinations in patients with low potassium reserves.
Category B .
Excreted in low concentrations in human milk.Tazobactam
Safety and efficacy not established in children younger than 2 mo of age.
Use with caution, usually starting at the low end of the dosage range, because of the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant diseases or other drug therapy.
Serious and sometimes fatal hypersensitivity reactions have occurred.
Adjust dose accordingly.
Prolonged use of antibiotics may result in bacterial or fungal overgrowth of nonsusceptible microorganisms.
Hemorrhagic manifestations associated with abnormalities of coagulation tests (bleeding time, platelet aggregation, PT) may occur. Abnormalities revert to normal when drug is discontinued.
May occur if higher than recommended doses are used.
May experience higher incidence of adverse reactions when treated with piperacillin.
Is unlikely to provide benefit and may increase risk of development of drug-resistant bacteria.
May occur because of overgrowth of Clostridium difficile ; consider the possibility in patients in whom diarrhea develops.
Product contains 2.79 mEq (64 mg) of sodium; consider this when treating patients requiring restricted sodium intake.
Convulsions, diarrhea, nausea, neuromuscular excitability, vomiting.
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