Anti-Pseudomonas penicillin + β-lactamase inhibitor (tazobactam)
Broad-spectrum penicillin plus beta-lactamase inhibitor combination indicated for intra-abdominal infections (complicated appendicitis, peritonitis), nosocomial pneumonia and other serious infections due to beta-lactamase-producing organisms, in adults and children ≥ 2 months.
Also known as: Piperacilina/Tazobactam
DailyMed approved label (Piperacillin and Tazobactam Injection; setID 4d3f4b69-b0b9-494f-9cda-4537fa420d47).
DailyMed approved label (Piperacillin and Tazobactam Injection; setID 4d3f4b69-b0b9-494f-9cda-4537fa420d47).
Piperacillin + Tazobactam may potentiate Warfarin and interfere with haemostasis, with a bleeding risk.
Piperacillin-tazobactam is a broad-spectrum antibiotic that reduces the gut flora producing vitamin K, decreasing the availability of the cofactor for carboxylation of the vitamin K-dependent coagulation factors. Since warfarin acts by inhibiting vitamin K epoxide reductase, the anticoagulant effect is potentiated and the INR rises. The risk is higher in critically ill, malnourished, liver-disease patients or with prolonged treatment — a frequent context for this antibiotic. Monitor the INR during and after treatment and adjust the warfarin dose; watch for bleeding.
Piperacillin-tazobactam can potentiate warfarin by reducing the gut flora that produces vitamin K. Monitor the INR during and after the antibiotic.
Reduction of vitamin-K-producing flora and platelet dysfunction (piperacillin may prolong bleeding time), especially at high doses and in renal impairment.
INR, renal function, platelet count, signs of bleeding.
Active bleeding, extensive bruising, haemoptysis/melena.
Monitor the INR and bleeding signs; consider warfarin adjustment and caution in renal patients or at high doses.
DailyMed/FDA (NIH/NLM) — approved Piperacillin + Tazobactam label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7aebc0e6-89db-4ef0-b5ab-d6b3199bcfc4 ; approved Warfarin label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=541c9a70-adaf-4ef3-94ba-ad4e70dfa057
No direct interaction is known between piperacillin + tazobactam and alcohol; caution is advised during treatment.
Limit alcohol intake during treatment.
DailyMed/FDA (NIH/NLM) — approved Piperacillin + Tazobactam label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7aebc0e6-89db-4ef0-b5ab-d6b3199bcfc4
Piperacillin + tazobactam is given intravenously; it has no significant food interaction.
No need to adjust dosing around meals.
DailyMed/FDA (NIH/NLM) — approved Piperacillin + Tazobactam label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7aebc0e6-89db-4ef0-b5ab-d6b3199bcfc4
Piperacillin and tazobactam are renally excreted; in renal impairment the dose and interval must be adjusted.
Adjust the dose to creatinine clearance.
DailyMed/FDA (NIH/NLM) — approved Piperacillin + Tazobactam label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7aebc0e6-89db-4ef0-b5ab-d6b3199bcfc4
Piperacillin is a penicillin; the combination is contraindicated in patients with prior penicillin allergy.
Contraindicated in penicillin allergy; choose an alternative from another class.
DailyMed/FDA (NIH/NLM) — approved Piperacillin + Tazobactam label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7aebc0e6-89db-4ef0-b5ab-d6b3199bcfc4
Human data are limited; piperacillin + tazobactam should be used in pregnancy only when the benefit justifies it (severe infections).
Use only in severe infections without an alternative.
Excreted into breast milk in small amounts; compatible with breastfeeding under supervision.
No specific additional contraception.
DailyMed/FDA (NIH/NLM) — approved Piperacillin + Tazobactam label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7aebc0e6-89db-4ef0-b5ab-d6b3199bcfc4
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
The pharmacodynamic parameter most predictive of clinical and microbiological efficacy is time above the MIC. The combination covers Gram-positives and Gram-negatives, including beta-lactamase-producing organisms and Pseudomonas aeruginosa.
Piperacillin inhibits bacterial cell-wall synthesis; tazobactam protects piperacillin from beta-lactamase hydrolysis (suicide beta-lactamase inhibitor).
Exclusively IV administration; after IV dosing, distribution is wide (V ~15–17 L), with good tissue penetration.
Piperacillin is partially metabolized (inactive desethylpiperacillin); tazobactam is metabolized to an inactive metabolite. Both are excreted mainly unchanged by the renal route.
Half-lives of ~0.7–0.9 h for piperacillin and ~0.7–0.8 h for tazobactam; prolonged in renal impairment.
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
