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piperacillin and tazobactam

Pronunciation

Generic Name: piperacillin and tazobactam (pi PER a sil in and tay zoe BAK tam)
Brand Name: Zosyn

What is piperacillin and tazobactam?

Piperacillin and tazobactam are penicillin antibiotics that fight bacteria in the body.

Piperacillin and tazobactam is a combination medicine used to treat many different infections caused by bacteria, such as urinary tract infections, bone and joint infections, severe vaginal infections, stomach infections, skin infections, and pneumonia.

This medication is sometimes given together with other antibiotics.

Piperacillin and tazobactam may also be used for purposes not listed in this medication guide.

What is the most important information I should know about piperacillin and tazobactam?

You should not use this medication if you are allergic to piperacillin and tazobactam or to any penicillin antibiotic (amoxicillin, ampicillin, Augmentin, dicloxacillin, oxacillin, penicillin, ticarcillin, and others).

Slideshow: Is it Safe to Give Human Medicine to Pets?

Always get your pet's drug and dose recommendation from the veterinarian.

What should I discuss with my healthcare provider before using piperacillin and tazobactam?

You should not use this medication if you are allergic to piperacillin and tazobactam or to any penicillin antibiotic (amoxicillin, ampicillin, Augmentin, dicloxacillin, oxacillin, penicillin, ticarcillin, and others).

To make sure piperacillin and tazobactam is safe for you, tell your doctor if you have:

  • kidney disease (or if you are on dialysis);

  • a bleeding or blood clotting disorder;

  • an electrolyte imbalance such as low levels of potassium in your blood;

  • cystic fibrosis;

  • a history of any type of allergy;

  • if you are on a low-salt diet; or

  • if you are allergic to a cephalosporin antibiotic such as cefdinir (Omnicef), cefprozil (Cefzil), cefuroxime (Ceftin), cephalexin (Keflex), and others.

FDA pregnancy category B. Piperacillin and tazobactam is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Piperacillin and tazobactam can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I use piperacillin and tazobactam?

Piperacillin and tazobactam is injected into a vein through an IV. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

Piperacillin and tazobactam is usually given for 7 to 10 days, depending on the infection being treated. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Piperacillin and tazobactam must be mixed with a liquid (diluent) before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medication.

Prepare your dose only when you are ready to give an injection. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.

If you use this medication long-term, you may need frequent medical tests at your doctor's office.

Use a disposable needle only once, then throw away in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Piperacillin and tazobactam will not treat a viral infection such as the common cold or flu.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using piperacillin and tazobactam.

Store unmixed medicine and the liquid diluent at cool room temperature.

Medicine mixed in an IV bag must be used within 24 hours if you keep it at room temperature.

Mixed medicine in an infusion pump must be used within 12 hours if you keep it at room temperature.

Mixed medication in an IV bag can also be stored in the refrigerator for up to 7 days. Do not freeze. Throw away any unused mixture that has not been used within that time.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using piperacillin and tazobactam?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Piperacillin and tazobactam side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • diarrhea that is watery or bloody;

  • pale or yellowed skin, dark colored urine, fever, confusion or weakness;

  • rapid heart rate, feeling light-headed or short of breath, trouble concentrating;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • dry mouth, increased thirst, confusion, increased urination, muscle pain or weakness, fast heart rate, fainting;

  • fever, chills, body aches, flu symptoms;

  • blisters or ulcers in your mouth, red or swollen gums, trouble swallowing;

  • seizure (convulsions); or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • nausea, vomiting, stomach pain or upset;

  • constipation, mild diarrhea;

  • headache, dizziness, agitation;

  • runny nose;

  • anxiety, sleep problems (insomnia);

  • skin rash or itching;

  • pain, swelling, or other irritation where the injection was given; or

  • vaginal itching or discharge.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Piperacillin and tazobactam dosing information

Usual Adult Dose for Intraabdominal Infection:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: for 7 to 10 days, depending 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

In severe infections, piperacillin trough levels (drawn immediately before the 4th or 5th dose) may be helpful. Serum piperacillin trough levels greater than 16 mcg/mL have been associated with improved efficacy.

Usual Adult Dose for Peritonitis:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: for 7 to 10 days, depending on the nature and severity of the infection

Usual Adult Dose for Skin or Soft Tissue Infection:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: for 7 to 10 days, depending on the nature and severity of the infection

Usual Adult Dose for Endometritis:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: Parenteral therapy should be continued for at least 24 hours after the patient has remained afebrile, pain-free, and the leukocyte count has normalized. Doxycycline therapy for 14 days is recommended if concurrent chlamydial infection is present in late postpartum patients (breast-feeding should be discontinued).

Usual Adult Dose for Pelvic Inflammatory Disease:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: for 7 to 10 days, depending on the nature and severity of the infection

If the patient is not pregnant, oral doxycycline therapy for 14 days should be considered to treat possible concurrent chlamydial infection. The patient's sexual partner(s) should also be evaluated.

Usual Adult Dose for Pneumonia:

Community-acquired pneumonia (moderate severity): 3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: for 7 to 10 days, depending on the nature and severity of the infection

Usual Adult Dose for Nosocomial Pneumonia:

Moderate to severe: 4.5 g IV every 6 hours

Duration: for 7 to 14 days, depending on the nature and severity of the infection

Initial empiric treatment with broad-spectrum coverage according to the hospital's and/or ICU's antibiogram is recommended if multidrug-resistant organisms are suspected.

If the causative organism is not Pseudomonas aeruginosa, the duration of treatment should be as short as clinically possible (e.g., as little as 7 days) to reduce the risk of superinfections with resistant organisms.

Usual Adult Dose for Aspiration Pneumonia:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: Parenteral therapy should be continued until the patient's clinical condition stabilizes and fever subsides. Oral antibiotic therapy may then be substituted according to microbiology sensitivity data. Therapy of documented anaerobic pleuropulmonary infections should be continued until the infiltrate is cleared, or a residual scar forms, sometimes for as long as 2 to 4 months.

Usual Adult Dose for Bacteremia:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: for approximately 14 days, depending 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

In severe infections, piperacillin trough levels (drawn immediately before the 4th or 5th dose) may be helpful. Serum piperacillin trough levels greater than 16 mcg/mL have been associated with improved efficacy.

Usual Adult Dose for Deep Neck Infection:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: for approximately 2 to 3 weeks, depending 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

Usual Adult Dose for Febrile Neutropenia:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: Therapy should be continued for about 14 days, or until more specific therapy may be substituted for a proven infection, or until the patient is afebrile for 24 hours after the absolute neutrophil count is greater than 500/mm3. The total duration of therapy depends 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.

In severe infections, piperacillin trough levels (drawn immediately before the 4th or 5th dose) may be helpful. Serum piperacillin trough levels greater than 16 mcg/ml have been associated with improved efficacy.

Usual Adult Dose for Joint Infection:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: Therapy should be continued for approximately 3 to 4 weeks, depending on the nature and severity of the infection. Longer therapy, 6 weeks or more, may be required for prosthetic joint infections. In addition, removal of the involved prosthesis is usually required.

Usual Adult Dose for Osteomyelitis:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: Therapy should be continued for approximately 4 to 6 weeks, depending on the nature and severity of the infection. Chronic osteomyelitis may require additional oral antibiotic therapy, possibly for up to 6 months. Surgical debridement of devitalized bone is critical to the management of osteomyelitis.

Usual Adult Dose for Pyelonephritis:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: for approximately 14 days, depending 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

Usual Adult Dose for Urinary Tract Infection:

3.375 g IV every 6 hours; 4.5 g IV every 8 hours has also been used

Duration: for approximately 7 to 10 days, depending 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

Usual Pediatric Dose for Peritonitis:

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

9 months or older:
40 kg or less: 100 mg/kg (piperacillin component) IV every 8 hours
Greater than 40 kg: 3.375 g IV every 6 hours

Usual Pediatric Dose for Appendicitis:

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

9 months or older:
40 kg or less: 100 mg/kg (piperacillin component) IV every 8 hours
Greater than 40 kg: 3.375 g IV every 6 hours

What other drugs will affect piperacillin and tazobactam?

Piperacillin and tazobactam may cause bleeding, especially in people who have kidney disease or use certain medicines. Tell your doctor if you are using any medication to prevent blood clots, such as:

  • heparin or warfarin (Coumadin);

  • argatroban, bivalirudin, dabigatran, fondaparinux, lepirudin, rivaroxaban;

  • abciximab, eptifibatide, tirofiban;

  • dalteparin, enoxaparin, tinzaparin;

  • anagrelide, cilostazol, clopidogrel, dipyridamole, eltrombopag, oprelvekin, prasugrel, romiplostim, ticagrelor, ticlopidine; or

  • alteplase, reteplase, tenecteplase, urokinase.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with piperacillin and tazobactam, especially:

  • methotrexate; or

  • probenecid.

These lists are not complete. Other drugs may interact with piperacillin and tazobactam, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about piperacillin and tazobactam.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.02. Revision Date: 2014-01-03, 4:47:38 PM.

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