Piperacillin/Tazobactam: Difference between revisions
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*Excretion:  
*Excretion:  
*Mechanism of Action:
*Mechanism of Action:
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||I
|-
| ||Strep. anginosus gp||'''S'''
|-
| ||[[Enterococcus faecalis]]||'''S'''
|-
| ||[[Enterococcus faecium]]||I
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||'''S'''
|-
| ||[[C. jeikeium]]||X1
|-
| ||[[L. monocytogenes]]||X2
|-
| Gram Negatives||[[N. gonorrhoeae]]||X2
|-
| ||[[N. meningitidis]]||'''S'''
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||'''S'''
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||'''S'''
|-
| ||[[Enterobacter]] sp, AmpC pos||'''S'''
|-
| ||[[Serratia]] sp||'''S'''
|-
| ||Serratia marcescens||X1
|-
| ||[[Salmonella]] sp||'''S'''
|-
| ||[[Shigella]] sp||'''S'''
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||'''S'''
|-
| ||[[Providencia sp.]]||'''S'''
|-
| ||[[Morganella sp.]]||'''S'''
|-
| ||[[Citrobacter freundii]]||'''S'''
|-
| ||[[Citrobacter diversus]]||'''S'''
|-
| ||[[Citrobacter sp.]]||'''S'''
|-
| ||[[Aeromonas sp]]||'''S'''
|-
| ||[[Acinetobacter sp.]]||I
|-
| ||[[Pseudomonas aeruginosa]]||'''S'''
|-
| ||[[Burkholderia cepacia]]||X1
|-
| ||[[Stenotrophomonas maltophilia]]||I
|-
| ||[[Yersinia enterocolitica]]||X1
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||X1
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||R
|-
| ||[[Mycoplasm pneumoniae]]||R
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||X1
|-
| ||[[Bacteroides fragilis]]||'''S'''
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||'''S'''
|-
| ||[[Fusobacterium necrophorum]]||'''S'''
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]
==Source==
==Source==


<references/>
<references/>
[[Category:Drugs]]
[[Category:Drugs]]

Revision as of 03:27, 24 June 2014

General

  • Type: Anti-Pseudomonal Penicillin
  • Dosage Forms:
  • Common Trade Names: Zosyn

Adult Dosing

General

  • 3.375 g IV q6 hours
  • Alt: 4.5 g q6-8 hours
  • Max: 18 g/day

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[1]
  • Nosocomial
    • 4.5 g IV q6 hours x 7-14 days
    • + aminoglycoside or antipseudomonal fluoroquinolone

Pediatric Dosing[2]

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[3]

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[4]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep I
Strep. anginosus gp S
Enterococcus faecalis S
Enterococcus faecium I
MSSA S
MRSA R
CA-MRSA R
Staph. Epidermidis S
C. jeikeium X1
L. monocytogenes X2
Gram Negatives N. gonorrhoeae X2
N. meningitidis S
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg S
Enterobacter sp, AmpC pos S
Serratia sp S
Serratia marcescens X1
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. S
Citrobacter freundii S
Citrobacter diversus S
Citrobacter sp. S
Aeromonas sp S
Acinetobacter sp. I
Pseudomonas aeruginosa S
Burkholderia cepacia X1
Stenotrophomonas maltophilia I
Yersinia enterocolitica X1
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida X1
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp R
Mycoplasm pneumoniae R
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces X1
Bacteroides fragilis S
Prevotella melaninogenica S
Clostridium difficile X1
Clostridium (not difficile) S
Fusobacterium necrophorum S
Peptostreptococcus sp. S

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

  1. ↑ Mandell, 2007
  2. ↑ Red Book, 2012
  3. ↑ 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
  4. ↑ Sanford Guide to Antimicrobial Therapy 2014
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