Piperacillin + Tazobactam

Class: Extended-spectrum penicillin + beta-lactamase inhibitor

Mechanism of Action: Piperacillin inhibits bacterial cell wall synthesis by binding to PBPs. Tazobactam inhibits beta-lactamases, protecting piperacillin from enzymatic degradation. Active against many Gram-positive, Gram-negative, and anaerobic bacteria.

Indications

• Severe intra-abdominal infections
• Complicated skin and soft tissue infections
• Hospital-acquired pneumonia
• Septicemia caused by susceptible organisms
• Urinary tract infections
• Febrile neutropenia in immunocompromised patients

Dosage

• Adults: 3.375 g IV every 6–8 hours (standard), 4.5 g IV every 6–8 hours for severe infections
• Children: 80 mg/kg IV piperacillin component every 8 hours
• Adjust dose in renal impairment

Maximum Dose

4.5 g every 6–8 hours (adults)

Major Side Effects

• Allergic reactions: rash, urticaria, anaphylaxis
• Gastrointestinal: diarrhea, nausea, vomiting
• Hematologic: thrombocytopenia, neutropenia (rare)
• Elevated liver enzymes
• Local reactions at injection site

Contraindications

• Hypersensitivity to penicillins or beta-lactams
• History of severe allergic reaction (anaphylaxis) to beta-lactams

Compatible Fluids

• 0.9% Sodium Chloride
• 5% Dextrose

Route of Administration

• Intravenous (IV) infusion only

Type of Administration

• IV: Infuse over 30 minutes; adjust infusion duration for critically ill patients or severe infections

Special Precautions

• Monitor renal function during prolonged therapy
• Monitor for allergic reactions
• Use cautiously in patients with history of seizures
• Prolonged therapy may lead to superinfection or Clostridioides difficile colitis