Indications:
Appendicitis (complicated by rupture or abscess) and peritonitis caused by
piperacillin-resistant, beta-lactamase producing strains of Escherichia coli or the following
members of the Bacteroides fragilis group: B. tragilis, B. ovatus, B. thetaiotaomicron, or B.
vulgatus.
Uncomplicated and complicated skin and skin structure infections, including cellulitis,
cutaneous abscesses and ischemicl diabetic foot infections caused by piperacillin-resistant,
beta-Iactamase producing strains of Staphylococcus aureus.
Postpartum endometritis or pelvic inflammatory disease caused by piperacillin-resistant,
beta-Iactamase producing strains of Escherichia coli .
Community-acquired pneumonia (moderate severity only) caused by
piperacillin-resistant, beta-Iactamase producing strains of Haemophilus influenzae.
Nosocomial pneumonia (moderate to severe) caused by piperacillin-resistant,
/ ß-Iactamase producing strains of Staphylococcus aureus and by piperacillin-tazobactam
susceptible Acinetobacter baumanii, Haemophilus influenzae, Klebsiella pneumoniae, and
Pseudomonas aeruginosa (Nosocomial pneumonia caused by P aeruginosa should be
treated in combination with an aminoglycoside).
Dosage and Administration:
Piperacillin and tazobactam should be administered by intravenous infusion over 30 minutes.
The usual total daily dose of Piperacillin and tazobactam for adults is 3.375 g every six hours
totaling 13.5 g (12.0 g piperacillin/1.5 g tazobactam).
Drug Interactions:
Aminoglycosides :
The mixing of beta-Iactam antibiotics with aminoglycosides in vitro can result in substantial
inactivation of the aminoglycoside. The inactivation of aminoglycosides in the presence of
penicillin-class drugs has been recognized. It has been postulated that
penicillin-aminoglycoside complexes form; these complexes are microbiologically inactive
and of unknown toxicity. Sequential administration of piperacillin and tazobactam with
tobramycin to patients with normal renal function and mild to moderate renal impairment has
been shown to modestly decrease serum concentrations of tobramycin but does not
significantly affect tobramycin pharmacokinetics. When aminoglycosides are administered in
combination with piperacillin to patients with end-stage renal disease requiring hemodialysis,
the concentrations of the aminoglycosides (especially tobramycin) may be significantly
altered and should be monitored. Since aminoglycosides are not equally susceptible to
inactivation by piperacillin, consideration should be given to the choice of the aminoglycoside
when administered in combination with piperacillin to these patients.
Contraindication:
Piperacillin and tazobactam is contraindicated in patients with a history of allergic reactions
to any of the penicillins, cephalosporins, or beta-Iactamase inhibitors.
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