Piperacillin Side Effects
Medically reviewed by Drugs.com. Last updated on Aug 9, 2022.
Applies to piperacillin: injectable powder for injection.
This drug was generally well tolerated. Local side effects (after IV or IM injection) were most common.[Ref]
Common (1% to 10%): Diarrhea, loose stools
Common (1% to 10%): Rash, pruritus
Frequency not reported: Vesicular eruptions/vesiculation, erythema multiforme, urticaria, toxic epidermal necrolysis, Stevens-Johnson syndrome, drug reactions with eosinophilia and systemic symptoms (DRESS), petechial rash/purpura, exanthematous pustulosis, bullous dermatosis, erythema nodosum, exanthems, exfoliative dermatitis, Jarisch-Herxheimer reaction[Ref]
An increased incidence of rash has been reported in cystic fibrosis patients.
DRESS has been reported, particularly with piperacillin-tazobactam.
Common (1% to 10%): Thrombophlebitis, injection site pain, injection site induration, injection site erythema
Thrombophlebitis was more likely when insufficiently diluted solution was injected into the vein.[Ref]
Common (1% to 10%): Drug fever
An increased incidence of fever has been reported in cystic fibrosis patients.
Frequency not reported: Anaphylactic/anaphylactoid reactions (some leading to shock and fatalities)[Ref]
Frequency not reported: Agranulocytosis, hemolytic anemia, leukopenia, neutropenia, pancytopenia, thrombocytopenia, eosinophilia, bleeding disorders, positive Coombs tests, hemorrhage/bleeding, decreased prothrombin time, platelet dysfunction, prolonged bleeding times[Ref]
Risk factors for reversible leukopenia (neutropenia) included prolonged therapy with high doses or concomitant drugs that cause this effect.[Ref]
Neuromuscular excitability and convulsions have been reported when higher than recommended doses were given IV.[Ref]
Frequency not reported: Epistaxis
More about piperacillin
- Check interactions
- Dosage information
- During pregnancy
- Drug class: antipseudomonal penicillins
Related treatment guides
1. Cerner Multum, Inc. "Canadian Product Information." O 0 (2015):
2. Winston DJ, Murphy W, Young LS, Hewitt WL "Piperacillin therapy for serious bacterial infections." Am J Med 69 (1980): 255-61
3. Lutz B, Mogabgab W, Holmes B, et al. "Clinical evaluation of the therapeutic efficacy and tolerability of piperacillin." Antimicrob Agents Chemother 22 (1982): 10-4
4. Eliopoulos GM, Moellering RC "Azlocillin, mezlocillin, and piperacillin: new broad-spectrum penicillins." Ann Intern Med 97 (1982): 755-60
5. Link AS, Jr "Efficacy and safety of ticarcillin plus clavulanic acid and piperacillin in patients with lower respiratory tract infections." Am J Med 79 (1985): 86-7
6. Mandell GL "In vitro microbiology and pharmacokinetics of piperacillin." Clin Ther 7 (1985): 37-44
7. "Product Information. Pipracil (piperacillin)." Lederle Laboratories (2001):
8. Ramakrishnan K, Scheid DC "Diagnosis and management of acute pyelonephritis in adults." Am Fam Physician 71 (2005): 933-42
9. Abate G, Godbole K, Springston C "Piperacillin/tazobactam-induced petechial rash." Ann Pharmacother 44 (2010): 1345-6
10. Strandvik B "Adverse reactions to piperacillin in patients with cystic fibrosis." Lancet 06/16/84 (1984): 1362
11. Stead RJ, Kennedy HG, Hodson ME, Batten JC "Adverse reactions to piperacillin in cystic fibrosis." Lancet 04/14/84 (1984): 857
12. Pleasants RA, Walker TR, Samuelson WM "Allergic reactions to parenteral beta-lactam antibiotics in patients with cystic fibrosis." Chest 106 (1994): 1124-8
13. Cabanas R, Munoz L, LopezSerrano C, Contreras J, Padial A, Caballero T, MorenoAncillo A, Barranco P "Hypersensitivity to piperacillin." Allergy 53 (1998): 819-20
14. Moore M, McNamara TR, Johnson J "Elevated bleeding time and epistaxis associated with piperacillin therapy." South Med J 78 (1985): 363
15. Kirkwood CF, Lasezkay GM "Neutropenia associated with mezlocillin and piperacillin." Drug Intell Clin Pharm 19 (1985): 112-4
16. Lee M, Stobnicki M, Sharifi R "Hemorrhagic complications of piperacillin therapy." J Urol 136 (1986): 454-5
17. Bressler RB, Huston DP "Piperacillin-induced anemia and leukopenia." South Med J 79 (1986): 255-6
18. Fass RJ, Copelan EA, Brandt JT, Moeschberger ML, Ashton JJ "Platelet-mediated bleeding caused by broad-spectrum penicillins." J Infect Dis 155 (1987): 1242-8
19. Gentry LO, Jemsek JG, Natelson EA "Effects of sodium piperacillin on platelet function in normal volunteers." Antimicrob Agents Chemother 19 (1981): 532-3
20. Singh N, Yu VL, Mieles LA, Wagener MM "Beta-lactam antibiotic-induced leukopenia in severe hepatic dysfunction: risk factors and implications for dosing in patients with liver disease." Am J Med 94 (1993): 251-6
21. Yan MT, Chu HY, Chau T, Lin SH "Profound thrombocytopenia associated with piperacillin in a hemodialysis patient." Clin Nephrol 72 (2009): 240-3
22. Mackie K, Pavlin EG "Recurrent paralysis following piperacillin administration." Anesthesiology 72 (1990): 561-3
23. Parkmatsumoto YC, Tazawa T "Piperacillin-induced encephalopathy." J Neurol Sci 140 (1996): 141-2
24. Malanga CJ, Kokontis L, Mauzy S "Piperacillin-induced seizures." Clin Pediatr (Phila) 36 (1997): 475-6
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Some side effects may not be reported. You may report them to the FDA.