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Piperacillin and Tazobactam for Injection, USP 40.5 grams: Recall - Precipitation or Crystallization in IV Bag or IV Line Upon Reconstitution

Audience: Risk Manager, Nursing, Health Professional

ISSUE: Apotex Corp. notified healthcare professionals it is conducting, on behalf of the manufacturer Hospira, Inc., a voluntary nationwide recall of 15 lots of Piperacillin and Tazobactam for Injection, USP 40.5 grams, to the hospital/healthcare provider/user level. The impacted lots may show precipitation/ crystallization in IV bag or IV line after reconstitution. The product can also be identified by NDC number 60505-0773-00 and UPC 360505077304. The product was distributed nationwide in the United States to wholesalers, distributors, HMOs, home infusion and long term care service providers. See Press Release for a list of affected lot numbers

Hospira stated that administration of precipitated Piperacillin/Tazobactam in an IV bag or IV line may result in local reactions such as phlebitis, renal impairment, end-organ embolism and ischemia, and/or vasculitis (because the precipitate was visible, its particles may be large enough to cause these adverse events). In addition, the precipitation of the drug may not allow delivering a needed therapeutic dose of piperacillin and tazobactam, thus resulting in inadequate treatment of the targeted infection. This could result in adverse health consequences that could range from transient and minor impairment or complaints to permanent impairment of a body function or permanent damage to a body structure.

BACKGROUND: Piperacillin and Tazobactam for Injection is indicated for the treatment of patients with moderate to severe infections caused by piperacillin-resistant, piperacillin/tazobactam-susceptable, ß-lactamase producing strains of the designated microorganisms in the specified conditions such as, Appendicitis, Uncomplicated and Complicated skin and skin structures infections, Postpartum Endometritis or Pelvic Inflammatory disease, Community Acquired Pneumonia and Nosocomial Pneumonia. The product is packaged in 300 mL glass vials for reconstitution.

RECOMMENDATION: Anyone with an existing inventory of the product should stop use and distribution, quarantine the recalled lots immediately and call GENCO at 1-877-674-2078 between the hours of 7 a.m. to 5 p.m. CST, Monday through Friday, to arrange for their return.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:


[04/26/2013 - Press Release - Apotex]

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