Zosyn (piperacillin/tazobactam) Disease Interactions
There are 5 disease interactions with Zosyn (piperacillin/tazobactam):
Antibiotics (Includes Zosyn) ↔ Colitis
Severe Potential Hazard, Moderate plausibility
Applies to: Colitis/Enteritis (Noninfectious)
Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to several weeks following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic-associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.
Beta-Lactams (Parenteral) (Includes Zosyn) ↔ Renal Dysfunction
Severe Potential Hazard, High plausibility
Applies to: Renal Dysfunction
Most beta-lactam antibiotics are eliminated by the kidney as unchanged drug and, in some cases, also as metabolites. The serum concentrations of beta-lactam antibiotics and their metabolites may be increased and the half-lives prolonged in patients with impaired renal function. Neurotoxic reactions, including encephalopathy, asterixis, myoclonus, seizures and coma, have been reported in such patients treated parenterally with these agents. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment as well as severity of infection in accordance with the individual product package labeling. Renal function tests should be performed periodically during prolonged and/or high-dose therapy, since nephrotoxicity and alterations in renal function have occasionally been associated with the use of these drugs.
Antipseudomonal Pcns (Includes Zosyn) ↔ Coagulation Abnormalities
Moderate Potential Hazard, Low plausibility
Applies to: Bleeding, Coagulation Defect, Renal Dysfunction, Thrombocytopathy, Thrombocytopenia, Vitamin K Deficiency
The use of extended-spectrum penicillin antibiotics has rarely been associated with coagulation abnormalities manifested as prolonged prothrombin and bleeding times, abnormal platelet aggregation, purpura, and clinical bleeding. These reactions have been most severe and most frequently reported in patients with renal impairment given high dosages of the drugs for prolonged periods, although they have also occurred with usual dosages in patients with normal renal function. Therapy with extended-spectrum penicillins should be administered cautiously in patients with significantly impaired renal function, severe active bleeding, or a hemorrhagic diathesis such as hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, or thrombocytopathy. Clinical monitoring of hematopoietic and renal function is recommended during prolonged and/or high-dose therapy. Bleeding manifestations are reversible upon discontinuation of the antibiotic.
Penicillins (Includes Zosyn) ↔ Hemodialysis
Moderate Potential Hazard, High plausibility
Applies to: hemodialysis
Penicillin antibiotics (except for agents in the penicillinase-resistant class) are removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.
Piperacillin (Includes Zosyn) ↔ Sodium/Potassium
Moderate Potential Hazard, Low plausibility
Applies to: Hypokalemia, Congestive Heart Failure, Fluid Retention, Hypertension, Hypernatremia
Parenteral piperacillin sodium contains approximately 43 mg (1.85 mEq) of sodium per each gram of piperacillin activity. The combination, piperacillin-tazobactam, contains approximately 54 mg (2.35 mEq) of sodium per gram of piperacillin, or 108 mg (4.7 mEq) per 2.25 gram of total drug. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention. In addition, hypokalemia has been reported rarely during therapy with piperacillin and other extended-spectrum penicillin antibiotics, which may be particularly important to bear in mind when treating patients with low potassium reserves or fluid and electrolyte imbalance. Clinical monitoring of electrolytes is recommended if these agents are used for prolonged periods.
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See also...
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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