Piperacillin/Tazobactam: Difference between revisions
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==General== | ==General== | ||
*Type: Anti-Pseudomonal [[Penicillin]] | *Type: Anti-Pseudomonal [[Penicillin]] | ||
*Dosage Forms: | *Dosage Forms: 2.25gm vial, 3.375gm vial, 4.5gm vial, 40.5gm bulk bottle(Powder for reconstitution) | ||
*Common Trade Names: Zosyn | *Common Trade Names: Zosyn | ||
Revision as of 23:28, 29 December 2014
General
- Type: Anti-Pseudomonal Penicillin
- Dosage Forms: 2.25gm vial, 3.375gm vial, 4.5gm vial, 40.5gm bulk bottle(Powder for reconstitution)
- Common Trade Names: Zosyn
Adult Dosing
General
- 3.375 g IV q6 hours
- Alt: 4.5 g q6-8 hours
- Max: 18 g/day
Extended Interval Dosing
- 3.375 g IV infused over 4 hours q8 hours (off-label)[1]
Diverticulitis
- 3.375 g IV q6 hours x 7-10 days
Pneumonia
- CAP
- 3.375 g IV q6 hours x 7-10 days
- Only for P. aeruginosa caused or from aspiration[2]
- Nosocomial
- 4.5 g IV q6 hours x 7-14 days
- + aminoglycoside or antipseudomonal fluoroquinolone
Pediatric Dosing[3]
A Piperacillin/Taxobactam 3.375g vial contains 3g piperacillin and 0.375g tazobactam (8:1 ratio)
General
- <2 months
- 100 mg piperacillin/kg/dose IV q6 hours
- 2-9 months
- 80 mg piperacillin/kg/dose IV q8 hours
- >9 months
- 100 mg piperacillin/kg/dose q8 hours
- Max: 16 g/day
Appendicitis and/or Peritonitis
- 2-9 months
- 80 mg piperacillin/kg/dose IV q8 hours
- >9 months
- ≤40 kg: 100 mg piperacillin/kg/dose IV q8 hours
- >40 kg: 3.375g (3000 mg piperacillin) IV q6 hours
- Max: 16 g/day
Cystic Fibrosis, Pseudomonal Infection
- 240-400 mg piperacillin/kg/day IV divided q8 hours;
- Consider higher dose: 450-600 mg/kg/day IV divided q4-6 hours[4]
Special Populations
- Pregnancy:
- Lactation:
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
Common
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
- Mechanism of Action:
Antibiotic Sensitivities[5]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
See Also
Source
- ↑ Shea KM, Cheatham SC, Smith DW, Wack MF, Sowinski KM, Kays MB. Comparative pharmacodynamics of intermittent and prolonged infusions of piperacillin/tazobactam using Monte Carlo simulations and steady-state pharmacokinetic data from hospitalized patients. Ann Pharmacother. 2009;43(11):1747-54.
- ↑ Mandell, 2007
- ↑ Red Book, 2012
- ↑ Zobell JT, Waters CD, Young DC, et al, "Optimization of Anti-Pseudomonal Antibiotics for Cystic Fibrosis Pulmonary Exacerbations: II. Cephalosporins and Penicillins," Pediatr Pulmonol, 2013, 48(2):107-22. PubMed 22949297
- ↑ Sanford Guide to Antimicrobial Therapy 2014