Generic Name: Piperacillin + Tazobactam Brand Name(s): .

Uses

What is Piperacillin + Tazobactam used for?

Piperacillin + Tazobactam is used to treat a wide variety of bacterial infections. It is a penicillin antibiotic. It works by stopping the growth of bacteria.

How should I take Piperacillin + Tazobactam?

This medication is given by injection into a vein as directed by your doctor, usually every 6 hours. It should be injected slowly over at least 30 minutes. The dosage is based on your medical condition and response to treatment. For children, the dosage is also based on age and weight.

If you are using this medication at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

If you are using the frozen pre-mixed solution, thaw the container at room temperature or in the refrigerator. If the bag is thawed in the refrigerator, let it sit at room temperature for at least 1 hour before using. Do not thaw by putting in warm/hot water or microwaving. After thawing, shake well and squeeze the container to check for leaks. Discard if the container leaks. Do not re-freeze the solution after thawing.

For the best effect, use this antibiotic at evenly spaced times. To help you remember, use this medication at the same time(s) every day.

Continue to use this medication for the full time prescribed, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.

Tell your doctor if your condition lasts or gets worse.

How do I store Piperacillin + Tazobactam?

Single dose vials should be used immediately after reconstitution. Discard any unused portion after 24 hours if stored at room temperature (20° to 25°C [68° to 77°F]), or after 48 hours if stored at refrigerated temperature (2° to 8°C [36° to 46°F]). Vials should not be frozen after reconstitution.

Piperacillin and Tazobactam for Injection, USP vials should be stored at controlled room temperature (20° to 25°C [68° to 77°F]) prior to reconstitution.

If you need to store piperacillin and tazobactam at home, talk with your doctor, nurse, or pharmacist about how to store it.

There may be different brands of Piperacillin + Tazobactam that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Piperacillin + Tazobactam down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Piperacillin + Tazobactam?

Before using piperacillin/tazobactam, tell your doctor or pharmacist if you are allergic to it; or to other antibiotics (such as penicillins, cephalosporins); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: cystic fibrosis, kidney disease.

This medication contains sodium. Consult your doctor or pharmacist if you are on a salt-restricted diet or if you have a condition that could be worsened by an increase in salt intake (such as heart failure, high blood pressure).

Piperacillin/tazobactam may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the extra sodium in this medication.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk in small amounts. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Piperacillin + Tazobactam during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Piperacillin + Tazobactam. Piperacillin + Tazobactam is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Piperacillin + Tazobactam?

Nausea, constipation, diarrhea, headache, or trouble sleeping may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding.

This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a type of resistant bacteria. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn’t stop, abdominal or stomach pain/cramping, blood/mucus in your stool.

Do not use anti-diarrhea products or narcotic pain medications if you have any of these symptoms because these products may make them worse.

Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.

Get medical help right away if you have any very serious side effects, including: seizures, signs of kidney problems (such as a change in the amount of urine).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever that doesn’t go away, new or worsening lymph node swelling, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Piperacillin + Tazobactam?

One product that may interact with this drug is: methotrexate.

Although most antibiotics are unlikely to affect hormonal birth control such as pills, patch, or ring, a few antibiotics (such as rifampin, rifabutin) can decrease their effectiveness. This could result in pregnancy. If you use hormonal birth control, ask your doctor or pharmacist for more details.

This medication may interfere with certain lab tests (including certain urine glucose tests), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Piperacillin + Tazobactam may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Piperacillin + Tazobactam?

Piperacillin + Tazobactam may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Piperacillin + Tazobactam?

Piperacillin + Tazobactam may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Piperacillin + Tazobactam.

What is the dose of Piperacillin + Tazobactam for an adult?

Usual Adult Dose for Intraabdominal Infection

3.375 g IV every 6 hours

Usual duration of therapy: 7 to 10 days

Uses: For the treatment of appendicitis (complicated by rupture or abscess) and peritonitis due to beta-lactamase-producing isolates of Escherichia coli or members of the Bacteroides fragilis group (B fragilis, B ovatus, B thetaiotaomicron, or B vulgatus)

Surgical Infection Society (SIS) and Infectious Diseases Society of America (IDSA) Recommendations: 3.375 g IV every 6 hours

-May increase for infections due to Pseudomonas aeruginosa: 3.375 g IV every 4 hours or 4.5 g IV every 6 hours

Comments:

-Recommended as an initial IV regimen for empiric treatment of complicated intraabdominal infection

-May be used for initial empiric treatment of high-risk/high-severity community-acquired extrabiliary complicated intraabdominal infection (e.g., severe physiologic disturbance, advanced age, immunocompromised state)

-Recommended for healthcare-associated intraabdominal infection, depending on local microbiologic studies

-May be used for initial empiric treatment of: high-risk/high-severity community-acquired acute cholecystitis; acute cholangitis after bilioenteric anastomosis (any severity); healthcare-associated biliary infection (any severity)

-Coadministration with other agents may be recommended.

-Current guidelines should be consulted for additional information.

International Society for Peritoneal Dialysis (ISPD) Recommendations:

Continuous (all exchanges):

-Loading dose: 4 g (piperacillin component) intraperitoneally

-Maintenance dose: 1 g (piperacillin component) intraperitoneally

Comments:

-When a surgical cause of peritoneal dialysis (PD)-related peritonitis is suspected, this drug may be considered as monotherapy.

-Current guidelines should be consulted for additional information.

Usual Adult Dose for Peritonitis

3.375 g IV every 6 hours

Usual duration of therapy: 7 to 10 days

Uses: For the treatment of appendicitis (complicated by rupture or abscess) and peritonitis due to beta-lactamase-producing isolates of Escherichia coli or members of the Bacteroides fragilis group (B fragilis, B ovatus, B thetaiotaomicron, or B vulgatus)

Surgical Infection Society (SIS) and Infectious Diseases Society of America (IDSA) Recommendations: 3.375 g IV every 6 hours

-May increase for infections due to Pseudomonas aeruginosa: 3.375 g IV every 4 hours or 4.5 g IV every 6 hours

Comments:

-Recommended as an initial IV regimen for empiric treatment of complicated intraabdominal infection

-May be used for initial empiric treatment of high-risk/high-severity community-acquired extrabiliary complicated intraabdominal infection (e.g., severe physiologic disturbance, advanced age, immunocompromised state)

-Recommended for healthcare-associated intraabdominal infection, depending on local microbiologic studies

-May be used for initial empiric treatment of: high-risk/high-severity community-acquired acute cholecystitis; acute cholangitis after bilioenteric anastomosis (any severity); healthcare-associated biliary infection (any severity)

-Coadministration with other agents may be recommended.

-Current guidelines should be consulted for additional information.

International Society for Peritoneal Dialysis (ISPD) Recommendations:

Continuous (all exchanges):

-Loading dose: 4 g (piperacillin component) intraperitoneally

-Maintenance dose: 1 g (piperacillin component) intraperitoneally

Comments:

-When a surgical cause of peritoneal dialysis (PD)-related peritonitis is suspected, this drug may be considered as monotherapy.

-Current guidelines should be consulted for additional information.

Usual Adult Dose for Appendicitis

3.375 g IV every 6 hours

Usual duration of therapy: 7 to 10 days

Uses: For the treatment of appendicitis (complicated by rupture or abscess) and peritonitis due to beta-lactamase-producing isolates of Escherichia coli or members of the Bacteroides fragilis group (B fragilis, B ovatus, B thetaiotaomicron, or B vulgatus)

Surgical Infection Society (SIS) and Infectious Diseases Society of America (IDSA) Recommendations: 3.375 g IV every 6 hours

-May increase for infections due to Pseudomonas aeruginosa: 3.375 g IV every 4 hours or 4.5 g IV every 6 hours

Comments:

-Recommended as an initial IV regimen for empiric treatment of complicated intraabdominal infection

-May be used for initial empiric treatment of high-risk/high-severity community-acquired extrabiliary complicated intraabdominal infection (e.g., severe physiologic disturbance, advanced age, immunocompromised state)

-Recommended for healthcare-associated intraabdominal infection, depending on local microbiologic studies

-May be used for initial empiric treatment of: high-risk/high-severity community-acquired acute cholecystitis; acute cholangitis after bilioenteric anastomosis (any severity); healthcare-associated biliary infection (any severity)

-Coadministration with other agents may be recommended.

-Current guidelines should be consulted for additional information.

International Society for Peritoneal Dialysis (ISPD) Recommendations:

Continuous (all exchanges):

-Loading dose: 4 g (piperacillin component) intraperitoneally

-Maintenance dose: 1 g (piperacillin component) intraperitoneally

Comments:

-When a surgical cause of peritoneal dialysis (PD)-related peritonitis is suspected, this drug may be considered as monotherapy.

-Current guidelines should be consulted for additional information.

Usual Adult Dose for Skin or Soft Tissue Infection

3.375 g IV every 6 hours

Usual duration of therapy: 7 to 10 days

Use: For the treatment of uncomplicated and complicated skin and skin structure infections (including cellulitis, cutaneous abscesses, ischemic/diabetic foot infections) due to beta-lactamase-producing isolates of Staphylococcus aureus

IDSA Recommendations:

-Incisional surgical site infection: 3.375 g IV every 6 hours or 4.5 g IV every 8 hours

-Necrotizing infections of the skin, fascia, and muscle: 3.375 g IV every 6 to 8 hours

-Infection after animal bite: 3.375 g IV every 6 to 8 hours

Comments:

-Recommended as a single-drug regimen for treatment of incisional surgical site infections after intestinal or genitourinary tract surgery

-With vancomycin, recommended as a preferred regimen for the treatment of necrotizing infections of the skin, fascia, and muscle due to mixed infections

-Infection after animal bite: This drug does not provide coverage for methicillin-resistant S aureus (MRSA).

-Current guidelines should be consulted for additional information.

Usual Adult Dose for Skin and Structure Infection

3.375 g IV every 6 hours

Usual duration of therapy: 7 to 10 days

Use: For the treatment of uncomplicated and complicated skin and skin structure infections (including cellulitis, cutaneous abscesses, ischemic/diabetic foot infections) due to beta-lactamase-producing isolates of Staphylococcus aureus

IDSA Recommendations:

-Incisional surgical site infection: 3.375 g IV every 6 hours or 4.5 g IV every 8 hours

-Necrotizing infections of the skin, fascia, and muscle: 3.375 g IV every 6 to 8 hours

-Infection after animal bite: 3.375 g IV every 6 to 8 hours

Comments:

-Recommended as a single-drug regimen for treatment of incisional surgical site infections after intestinal or genitourinary tract surgery

-With vancomycin, recommended as a preferred regimen for the treatment of necrotizing infections of the skin, fascia, and muscle due to mixed infections

-Infection after animal bite: This drug does not provide coverage for methicillin-resistant S aureus (MRSA).

-Current guidelines should be consulted for additional information.

Usual Adult Dose for Pelvic Inflammatory Disease

3.375 g IV every 6 hours

Usual duration of therapy: 7 to 10 days

Use: For the treatment of postpartum endometritis or pelvic inflammatory disease due to beta-lactamase-producing isolates of E coli

Usual Adult Dose for Endometritis

3.375 g IV every 6 hours

Usual duration of therapy: 7 to 10 days

Use: For the treatment of postpartum endometritis or pelvic inflammatory disease due to beta-lactamase-producing isolates of E coli

Usual Adult Dose for Pneumonia

3.375 g IV every 6 hours

Usual duration of therapy: 7 to 10 days

Use: For the treatment of community-acquired pneumonia (moderate severity only) due to beta-lactamase-producing isolates of Haemophilus influenzae

Usual Adult Dose for Nosocomial Pneumonia

4.5 g IV every 6 hours

Duration of therapy: 7 to 14 days

Comments:

-Initial presumptive therapy should start with this drug plus an aminoglycoside.

-Aminoglycoside therapy should be continued if P aeruginosa is isolated.

Use: For the treatment of moderate to severe nosocomial pneumonia due to beta-lactamase-producing isolates of S aureus and by piperacillin-tazobactam-susceptible Acinetobacter baumannii, H influenzae, Klebsiella pneumoniae, and P aeruginosa

IDSA and American Thoracic Society Recommendations: 4.5 g IV every 6 hours

Duration of therapy: 7 days

Comments:

-Recommended as an empiric treatment regimen for clinically suspected ventilator-associated pneumonia in units where such coverage is appropriate

-Recommended as initial empiric therapy for hospital-acquired pneumonia (non-ventilator-associated pneumonia)

-Current guidelines should be consulted for additional information.

Usual Adult Dose for Surgical Prophylaxis

American Society of Health-System Pharmacists (ASHP), IDSA, SIS, and Society for Healthcare Epidemiology of America (SHEA) Recommendations:

-Preoperative dose: 3.375 g IV as a single dose

-Redosing interval (from start of preoperative dose): 2 hours

Comments:

-Recommended for perioperative prophylaxis to prevent surgical-site infections in patients undergoing liver transplantation

-This drug should be started within 60 minutes before surgical incision.

-A single prophylactic dose is usually sufficient; if prophylaxis is continued postoperatively, duration should be less than 24 hours.

-To ensure adequate serum and tissue drug levels, readministration may be needed if the procedure duration exceeds the recommended redosing interval.

-Redosing may be needed if drug half-life is shortened (e.g., extensive burns) or if prolonged/excessive bleeding during surgery; redosing may not be needed if drug half-life is prolonged (e.g., renal dysfunction).

-Coadministration with other agents may be recommended.

-Current guidelines should be consulted for additional information.

Usual Adult Dose for Pyelonephritis

Some experts recommend: 3.375 to 4.5 g IV every 6 to 8 hours

Duration of therapy: About 14 days

Comments:

-Dose and therapy duration depend on the nature and severity of the infection.

-Once the patient is stable and able to tolerate oral medications, oral antibiotic therapy may be substituted according to microbiology sensitivity data.

-Current guidelines should be consulted for additional information.

Renal Dose Adjustments

Adults:

CrCl greater than 40 mL/min: No adjustment recommended.

CrCl 20 to 40 mL/min:

-Nosocomial pneumonia: 3.375 g IV every 6 hours

-Other indications: 2.25 g IV every 6 hours

CrCl less than 20 mL/min:

-Nosocomial pneumonia: 2.25 g IV every 6 hours

-Other indications: 2.25 g IV every 8 hours

Pediatric patients: Data not available

Liver Dose Adjustments

Hepatic cirrhosis: No adjustment recommended.

Dialysis

Hemodialysis, CAPD:

-Nosocomial pneumonia: 2.25 g IV every 8 hours

-Other indications: 2.25 g IV every 12 hours

Continuous venovenous hemofiltration (CVVH): Some experts recommend piperacillin-tazobactam 2.25 to 3.375 g every 8 hours for initial therapy of patients undergoing CVVH, and then intermittent doses of piperacillin alone to prevent tazobactam accumulation.

Comments:

-A supplemental dose of 0.75 g piperacillin-tazobactam should be given after each hemodialysis session.

-No supplemental doses are needed for CAPD patients.

-Clearance may be significantly increased in patients undergoing continuous renal replacement therapy (CRRT) and higher doses may be necessary which should be individualized based on estimated piperacillin-tazobactam clearance. In addition, tazobactam has a longer half-life than piperacillin, resulting in relative serum level increases compared to piperacillin.

Other Comments

4.5 g piperacillin-tazobactam contains 4 g piperacillin and 500 mg tazobactam

3.375 g piperacillin-tazobactam contains 3 g piperacillin and 375 mg tazobactam

2.25 g piperacillin-tazobactam contains 2 g piperacillin and 250 mg tazobactam

0.75 g piperacillin-tazobactam contains 670 mg piperacillin and 80 mg tazobactam

Administration advice:

-Administer via IV infusion over 30 minutes.

-During infusion of this drug, discontinue the primary infusion solution.

-Do not mix with other drugs in a syringe or infusion bottle.

-Galaxy(R) Containers: Do not use plastic containers in series connections.

-Reconstitute, dilute, and administer this drug and aminoglycosides separately when concurrent use of aminoglycosides is indicated; consult the manufacturer product information regarding coadministration via Y-site infusion.

Storage requirements:

-Galaxy(R) Containers: Store at or below -20C (-4F); thawed solution is stable for 24 hours at 20C to 25C (68F to 77F) or for 14 days at 2C to 8C (36F to 46F); do not refreeze.

-Vials: Store at controlled room temperature 20C to 25C (68F to 77F) before reconstitution; the manufacturer product information should be consulted regarding storage and stability of reconstituted and/or further diluted solutions.

Reconstitution/preparation techniques:

-Galaxy(R) Containers: Thaw frozen container at room temperature 20C to 25C (68F to 77F) or in refrigerator 2C to 8C (36F to 46F); do not force thaw by immersion in water baths or by microwave irradiation.

-Vials: Reconstitution and further dilution needed; the manufacturer product information should be consulted.

IV compatibility:

-Compatible reconstitution diluents for vials: 0.9% sodium chloride injection; sterile water for injection; dextrose 5%; bacteriostatic saline/parabens; bacteriostatic water/parabens; bacteriostatic saline/benzyl alcohol

-Compatible IV solutions for vials: 0.9% sodium chloride injection; sterile water for injection; dextran 6% in saline; dextrose 5%

—Lactated Ringers Solution is compatible only with the reformulated product containing edetate disodium dihydrate (EDTA); compatible for coadministration via Y-site.

-Incompatible: Solutions containing only sodium bicarbonate; solutions that alter pH significantly; blood products; albumin hydrolysates

-Galaxy(R) Containers: Do not add supplementary medication; product containing EDTA is compatible for coadministration via Y-site IV tube with Lactated Ringers injection, USP.

General:

-This drug is for the treatment of moderate to severe infections due to susceptible isolates of the designated bacteria.

-To reduce the development of drug-resistant organisms and maintain effective therapy, this drug should be used only to treat or prevent infections proven or strongly suspected to be caused by susceptible bacteria.

-Culture and susceptibility information should be considered when selecting/modifying antibacterial therapy or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy.

-Sodium content is about 2.84 mEq (65 mg) per gram of piperacillin; at usual recommended doses, patients would receive about 34.1 to 45.5 mEq/day (780 to 1040 mg/day) of sodium.

Monitoring:

-Hematologic: Hematopoietic function (periodically, especially during prolonged therapy)

-Metabolic: Electrolytes in patients with low potassium reserves (periodically)

-Renal: Renal function in elderly patients

Patient advice:

-Avoid missing doses and complete the entire course of therapy.

-Consult physician at once if watery and bloody stools (with or without stomach cramps and fever) develop.

What is the dose of Piperacillin + Tazobactam for a child?

Usual Pediatric Dose for Intraabdominal Infection

2 to 9 months: 80 mg/kg (piperacillin component) IV every 8 hours

9 months or older:

-Up to 40 kg: 100 mg/kg (piperacillin component) IV every 8 hours

-Greater than 40 kg: 3.375 g IV every 6 hours

Usual duration of therapy: 7 to 10 days

Uses: For the treatment of appendicitis (complicated by rupture or abscess) and peritonitis due to beta-lactamase-producing isolates of E coli or members of the B fragilis group (B fragilis, B ovatus, B thetaiotaomicron, or B vulgatus)

SIS and IDSA Recommendations: 200 to 300 mg/kg/day (piperacillin component) IV in divided doses every 6 to 8 hours

Maximum dose: 12 g/day (based on piperacillin component)

Comments:

-Recommended as an initial IV regimen for treatment of complicated intraabdominal infection

-May be used for initial empiric treatment of community-acquired extrabiliary complicated intraabdominal infection

-Doses should be maximized if undrained intraabdominal abscess may be present.

-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Peritonitis

2 to 9 months: 80 mg/kg (piperacillin component) IV every 8 hours

9 months or older:

-Up to 40 kg: 100 mg/kg (piperacillin component) IV every 8 hours

-Greater than 40 kg: 3.375 g IV every 6 hours

Usual duration of therapy: 7 to 10 days

Uses: For the treatment of appendicitis (complicated by rupture or abscess) and peritonitis due to beta-lactamase-producing isolates of E coli or members of the B fragilis group (B fragilis, B ovatus, B thetaiotaomicron, or B vulgatus)

SIS and IDSA Recommendations: 200 to 300 mg/kg/day (piperacillin component) IV in divided doses every 6 to 8 hours

Maximum dose: 12 g/day (based on piperacillin component)

Comments:

-Recommended as an initial IV regimen for treatment of complicated intraabdominal infection

-May be used for initial empiric treatment of community-acquired extrabiliary complicated intraabdominal infection

-Doses should be maximized if undrained intraabdominal abscess may be present.

-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Appendicitis

2 to 9 months: 80 mg/kg (piperacillin component) IV every 8 hours

9 months or older:

-Up to 40 kg: 100 mg/kg (piperacillin component) IV every 8 hours

-Greater than 40 kg: 3.375 g IV every 6 hours

Usual duration of therapy: 7 to 10 days

Uses: For the treatment of appendicitis (complicated by rupture or abscess) and peritonitis due to beta-lactamase-producing isolates of E coli or members of the B fragilis group (B fragilis, B ovatus, B thetaiotaomicron, or B vulgatus)

SIS and IDSA Recommendations: 200 to 300 mg/kg/day (piperacillin component) IV in divided doses every 6 to 8 hours

Maximum dose: 12 g/day (based on piperacillin component)

Comments:

-Recommended as an initial IV regimen for treatment of complicated intraabdominal infection

-May be used for initial empiric treatment of community-acquired extrabiliary complicated intraabdominal infection

-Doses should be maximized if undrained intraabdominal abscess may be present.

-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Bacterial Infection

American Academy of Pediatrics (AAP) Recommendations:

Neonates:

7 days or younger: 100 mg/kg (piperacillin component) IV every 12 hours

8 to 28 days: 100 mg/kg (piperacillin component) IV every 8 hours

2 to 9 months:

-Severe infections: 80 mg/kg (piperacillin component) IV 3 times a day

9 months or older:

-Severe infections: 100 mg/kg (piperacillin component) IV 3 times a day

Maximum dose: 16 g/day (based on piperacillin component)

Usual Pediatric Dose for Endocarditis

American Heart Association Recommendations:

Children and adolescents: 240 mg/kg/day (piperacillin component) IV in divided doses every 8 hours

Maximum dose: 18 g/day (based on piperacillin component)

Duration of therapy: At least 6 weeks

Comments:

-With an aminoglycoside, recommended as an alternative regimen for the treatment of infective endocarditis due to gram-negative enteric bacilli

-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Skin or Soft Tissue Infection

IDSA Recommendations:

1 month or older: 60 to 75 mg/kg (piperacillin component) IV every 6 hours

Maximum dose: 3 g/dose (based on piperacillin component)

Comments:

-With vancomycin, recommended as a preferred regimen for the treatment of necrotizing infections of the skin, fascia, and muscle due to mixed infections

-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Skin and Structure Infection

IDSA Recommendations:

1 month or older: 60 to 75 mg/kg (piperacillin component) IV every 6 hours

Maximum dose: 3 g/dose (based on piperacillin component)

Comments:

-With vancomycin, recommended as a preferred regimen for the treatment of necrotizing infections of the skin, fascia, and muscle due to mixed infections

-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Surgical Prophylaxis

ASHP, IDSA, SIS, and SHEA Recommendations:

Preoperative dose:

-Infants 2 to 9 months: 80 mg/kg (piperacillin component) IV as a single dose

-Children older than 9 months and up to 40 kg: 100 mg/kg (piperacillin component) IV as a single dose

—Maximum dose: 3 g/dose (based on piperacillin component)

Redosing interval (from start of preoperative dose): 2 hours

Comments:

-Recommended for perioperative prophylaxis to prevent surgical-site infections in patients undergoing liver transplantation

-This drug should be started within 60 minutes before surgical incision.

-A single prophylactic dose is usually sufficient; if prophylaxis is continued postoperatively, duration should be less than 24 hours.

-To ensure adequate serum and tissue drug levels, readministration may be needed if the procedure duration exceeds the recommended redosing interval.

-Redosing may be needed if drug half-life is shortened (e.g., extensive burns) or if prolonged/excessive bleeding during surgery; redosing may not be needed if drug half-life is prolonged (e.g., renal dysfunction).

-Coadministration with other agents may be recommended.

-Current guidelines should be consulted for additional information.

Precautions

Safety and efficacy have not been established in patients younger than 2 months.

How is Piperacillin + Tazobactam available?

Piperacillin + Tazobactam is available in the following dosage forms and strengths:

  • Intravenous powder for injection,
  • Intravenous solution.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Piperacillin + Tazobactam, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: April 11, 2018 | Last Modified: April 11, 2018

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